Korean J Ophthalmol.  2008 Sep;22(3):174-177. 10.3341/kjo.2008.22.3.174.

The Effect of Unilateral Medial Rectus Muscle Resection in Patients with Recurrent Exotropia

• Chae SH
• Chun BY
• Kwon JY

• KMID: 1070753
• DOI: http://doi.org/10.3341/kjo.2008.22.3.174

Abstract

PURPOSE: To investigate the effect of unilateral medial rectus muscle resection for recurrent exotropia after bilateral lateral rectus muscle recession for intermittent exotropia METHODS: A retrospective analysis was made of thirtypatients who underwent unilateral medial rectus resection for recurrent exotropia. All had prior bilateral lateral rectus recession for intermittent exotropia. Data were collected for age, the preoperative deviation, the postoperative deviation at 2 weeks, 3 months, 6 months and the last visit, and the amount of medial rectus resection performed. RESULTS: The average preoperative deviation was 27.0+/-3.6 PD. After unilateral medial rectus resection, average deviation at distance was 2.8 PD at postoperative 2 weeks, 4.5 PD at 3 months, 5.1 PD at 6 months and 5.8 PD at last visit. The average deviation corrected per millimeter of medial rectus resection was 3.53+/-0.17 PD/mm. CONCLUSIONS: Considering that deviation angles of recurrent exotropia is smaller than those of primary surgery and the possibility of saving the other medial rectus muscle, unilateral rectus muscle resection could be effective surgical method for recurrent exotropia.

Keyword

Intermittent exotropia; Recurrence; Unilateral medial rectus muscle resection.

MeSH Terms

Child
Exotropia/*surgery
Female
Humans
Male
Oculomotor Muscles/*surgery
*Ophthalmologic Surgical Procedures
Recurrence
Refraction, Ocular
Retrospective Studies

Figure

• 

  Fig. 1 Distribution of the mean deviation angle according to follow-up duration after unilateral MR resection for recurrent exotropia.

• 

  Fig. 2 Success rate according to follow-up duration after unilateral MR resection.

Reference

1. Scott WE, Keech R, Marsh AJ. The postoperative results and stability of exodeviations. Arch Ophthalmol. 1981. 99:1814–1818.

2. Hahm KH, Shin MC, Sohn MA. The change in deviation angle with time cource after surgical correction of intermittent exotropia. J Korean Ophthalmol Soc. 2002. 42:2220–2226.

3. Olitsky SE, Kelly C, Lee H, Nelson LB. Unilateral rectus resection in the treatment of undercorrected or recurrent strabismus. J Pediatr Ophthalmol Strabismus. 2001. 38:349–353.

4. Parks MM, Mitchell PR. Tamsan W, Jaeger E, editors. Concomitant exodeviations. Clinical ophthalmology. 1991. vol. 1. Philadelphia: JB Lippincott;chapter 13.

5. Yazdian Z, Ghiassi G. Re-recession of the lateral rectus muscles in patients with recurrent exotropia. J AAPOS. 2006. 10:164–167.

6. Kang SJ, Jang JH. Motility restriction after resection of an extraocular muscle. Korean J Ophthalmol. 2001. 15:133–136.

7. Sohn JH, Chang BL. Management for reoperation in recurrent exotropia. J Korean Ophthalmol Soc. 1994. 36:2661–2665.

8. Hahm IR, Yoon SW, Baek SH, Kong SM. The clinical course of recurrent exotropia after reoperation for exodeviation. Korean J Ophthalmol. 2005. 19:140–144.

9. Kim JY, Chang BL. The effect of unilateral lateral rectus recession in recurrent exotropia. J Korean Ophthalmol Soc. 1995. 36:2261–2265.

10. Grin TR, Nelson LB. Large unilateral medial rectus muscle recession for the treatment of esotropia. Br J Ophthalmol. 1987. 71:377–379.

11. Olitsky SE. Early and late postoperative alignment following unilateral lateral rectus recession for intermittent exotropia. J Pediatr Ophthalmol Strabismus. 1998. 35:146–148.

12. Mims JL 3rd. Outcome of 5 mm resection of one medial rectus extraocular muscle for recurrent exotropia. Binocul Vis Strabismus Q. 2003. 18:143–150.

13. Kim SC, Kim MM. The efficacy of unilateral rectus resection in the reoperation of strabismus. J Korean Ophthalmol Soc. 2003. 44:904–910.