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Comparison of bilateral lateral rectus recession and unilateral recession resection for basic type intermittent
Lihua Wang1, Qizheng Wu, Xiangyun Kong
1Department of Ophthalmology, Provincial Hospital affiliated to Shandong University, Jinan, Shandong, PR China. wang_glasses@yahoo.com.cn
Insights
For children with basic intermittent exotropia (IXT), the unilateral lateral rectus recession combined with medial rectus resection (R&R) surgery demonstrated a higher success rate and lower undercorrection rate compared to bilateral lateral rectus recession (BLR-rec) surgery.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Strabismus Surgery
Background:
- Intermittent exotropia (IXT) is a common strabismus in children.
- Surgical management aims to restore binocular vision and improve alignment.
- Two common surgical approaches include bilateral lateral rectus recession (BLR-rec) and unilateral lateral rectus recession with medial rectus resection (R&R).
Purpose of the Study:
- To compare the surgical outcomes of BLR-rec and R&R for basic type IXT in pediatric patients.
- To evaluate the efficacy and safety of these two surgical techniques.
Main Methods:
- Retrospective review of 85 children (aged 3-15) with basic IXT.
- Patients underwent either BLR-rec (38 patients) or R&R (47 patients).
- Surgical success defined as alignment within ±5 to ±8 prism diopters (PD) in primary gaze; minimum 6-month follow-up.
Main Results:
- The R&R group showed a significantly higher success rate (85.1%) compared to the BLR-rec group (65.8%) (p=0.037).
- Undercorrection rates were significantly lower in the R&R group (6.4%) versus the BLR-rec group (23.7%) (p=0.023).
- No significant difference in overcorrection rates between the two surgical groups (p=1.000).
Conclusions:
- Unilateral lateral rectus recession combined with medial rectus resection (R&R) is more effective than bilateral lateral rectus recession (BLR-rec) for treating basic intermittent exotropia in children.
- R&R offers superior long-term surgical outcomes for this condition.
Aims:
To compare surgical outcome of bilateral lateral rectus recession (BLR-rec) and unilateral lateral rectus recession combined with medial rectus resection (R&R) for the basic type of intermittent exotropia (IXT) in children.
Methods:
Eighty-five consecutive patients aged 3-15 years old with the basic type IXT who underwent surgery and had a minimum postoperative follow-up of 6 months were retrospectively reviewed. Thirty-eight patients underwent BLR-rec and 47 underwent R&R. Successful surgical alignment was defined as esophoria/tropia ≤5 PD (prism dioptres) to exophoria/tropia ≤8 PD in primary gaze while viewing distant or near targets.
Results:
After a mean follow-up of 14.8 ± 9.5 months, the subjects who had undergone R&R surgery had a significantly higher success rate than those who had BLR-rec surgery (85.1% vs 65.8%, p=0.037). The undercorrection rate was significantly lower in the R&R group than in the BLR-rec group (6.4% vs 23.7%, p=0.023) and there was no significant difference in the overcorrection rate between the two groups (10.5% vs 8.5%, p=1.000).
Conclusions:
R&R is more effective than BLR-rec surgery in the long term for the basic type IXT in children.
