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Efficacy of medial rectus plication versus resection for exotropia: a meta-analysis

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Abstract

Objective

To compare the outcomes of medial rectus plication and medial rectus resection procedures in the treatment of exotropia.

Methods

Articles from Pubmed, EMBASE, Web of Science, and Cochrane Library databases until July 2021 with a minimum follow-up period of 1 month were retrieved. No restriction on language was applied. Eligible studies must comply with the inclusion criteria. Only studies with comparisons between unilateral medial rectus plication versus unilateral medial rectus resection, unilateral lateral rectus recession-medial rectus plication (RP) versus unilateral lateral rectus recession-medial rectus resection (RR), or bilateral medial rectus plication(BMRP) versus bilateral medial rectus resection (BMRR) would be included for subsequent analysis. Two primary outcomes were specified: success rate and mean postoperative deviation. Dichotomous data were calculated as pooled odds ratios (ORs) with 95% confidence intervals (CIs) and continuous data as weighted mean differences (WMD) with 95% CIs.

Results

A total of 8 studies with 557 participants were enrolled in the meta-analysis based on the inclusion criteria. Seven studies compared lateral rectus recession + medial rectus plication to unilateral lateral rectus recession + medial rectus resection and one study compared bilateral medial rectus plication to bilateral medial rectus resection. Differences in success rates between plication and resection groups were not statistically significant (OR = 0.66; 95% CI, 0.43–1.02; P = 0.06), and the unsatisfactory effects (the undercorrection and overcorrection rates) between the two groups were comparable. Additionally, there were also no significant differences in postoperative deviation and the amount of exodrift between the two groups.

Conclusion

This meta-analysis provides evidence that both the medial rectus plication and medial rectus resection procedures have similar efficacy in the treatment of exotropia.

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Acknowledgements

We are very grateful to Jing Qian and Yixia Du who were involved in the early phases of the review including contributing to the design of the search strategies and screening. We would also like to thank Zhijun Chen for administrative support.

Funding

This work was funded by the Young Medical Talents Foundation of Jiangsu Province.

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Authors and Affiliations

  1. Department of Ophthalmology, Children’s Hospital of Nanjing Medical University, Nanjing, 210008, Jiangsu Province, China

    Desheng Song, Jing Qian & Zhijun Chen

Authors
  1. Desheng Song
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  2. Jing Qian
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  3. Zhijun Chen
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Contributions

Desheng Song and Zhijun Chen conceived the study. Jing Qian designed and performed the searches. Desheng Song and Jing Qian conducted data extraction, appraisal, and synthesis and wrote the manuscript. All authors participated in discussions about the eligibility and quality of the included studies and critically reviewed and approved the final version of the manuscript.

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Correspondence to Desheng Song.

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This article does not contain any studies with human participants performed by any of the authors.

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The authors declare no competing interests.

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Song, D., Qian, J. & Chen, Z. Efficacy of medial rectus plication versus resection for exotropia: a meta-analysis. Graefes Arch Clin Exp Ophthalmol 260, 2095–2101 (2022). https://doi.org/10.1007/s00417-022-05589-7

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  • DOI: https://doi.org/10.1007/s00417-022-05589-7

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