J Korean Ophthalmol Soc.  2018 Jun;59(6):577-581. 10.3341/jkos.2018.59.6.577.

The Effect of Bilateral Medial Rectus Resection for Recurrent Intermittent Exotropia

Affiliations
  • 1Department of Ophthalmology, Chonbuk National University Medical School, Jeonju, Korea. ahnmin@jbnu.ac.kr
  • 2Research Institute of Clinical Medicine, Chonbuk National University, Jeonju, Korea.
  • 3Biomedical Research Institute, Chonbuk National University Hospital, Jeonju, Korea.

Abstract

PURPOSE
The purpose of this study was to investigate the effect of bilateral medial rectus muscle resection on the treatment of recurrent intermittent exotropia.
METHODS
A retrospective chart analysis was conducted for 25 patients who underwent bilateral medial rectus resection for recurrent exotropia over 20 prism diopters (PD) between January 2009 and August 2015. The medial rectus was resected from 4.0 to 6.5 mm by 0.5 mm according to the deviation angle. The postoperative angle of deviation was checked at 1 day, 1 week, 3 months, 6 months, and 1 year postoperatively to investigate the amount of corrected deviation per resected muscle.
RESULTS
The average preoperative deviation angle was 27.20 ± 5.02 PD exodeviation and the mean resection was 5.10 ± 0.79 mm of the medial rectus. The postoperative angle deviation was 10.68 ± 5.50 PD esodeviation at 1 day. The incidence of esodeviation tended to decrease over time. At 1 year, the postoperative angle deviation was 1.16 ± 7.54 PD esodeviation. The overcorrection rate was 84% at 1 day postoperatively but decreased to 24% at 1 year with a success rate of 68%. The corrected deviation angle per millimeter was 7.53 ± 1.22, 7.75 ± 2.16, 6.27 ± 1.74, 5.50 ± 1.54, and 5.56 ± 1.58 PD/mm at 1 day, 1 week, 3 months, 6 months, and 1 year after surgery, respectively. The dose effect per millimeter decreased over time. The corrected deviated angle per millimeter remained constant regardless of the amount of medial rectus muscle resection at 1 year postoperatively(p=0.939).
CONCLUSIONS
Bilateral medial rectus resection for recurrent exotropia over 20 PD tended to overcorrect at first; however, after 1 year, the mean angle of deviation was 1.16 ± 7.54 PD esodeviation. Bilateral medial rectus resection is an effective surgical method for the treatment of recurrent exotropia over 20 PD.

Keyword

Bilateral lateral rectus recession; Bilateral medial rectus resection; Recurrent exotropia

MeSH Terms

Esotropia
Exotropia*
Humans
Incidence
Methods
Retrospective Studies

Figure

  • Figure 1 Surgical outcome of bimedial rectus resection with the course of time. The overcorrection rate decreased to 24% and the success rate increased to 68% at 1 year after bilateral medial rectus resection. *Success was defined as distant deviation in the primary position between 10 PD of exodeviation and 5 PD of esodeviation; †Overcorrection was defined as distant deviation in the primary position over 5 PD of esodeviation; ‡Undercorrection was defined as distant deviation in the primary position over 10 PD of exodeviation.


Cited by  1 articles

Surgical Outcomes of Modified Medial Rectus Resections in Recurrent Intermittent Exotropia
Kwang Hyun Kim, Joo Yeon Lee
J Korean Ophthalmol Soc. 2019;60(11):1098-1104.    doi: 10.3341/jkos.2019.60.11.1098.


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