Ocular alignment after bilateral lateral rectus recession in exotropic children with cerebral palsy

Area of Science:

• Ophthalmology
• Neurology
• Pediatric Surgery

Background:

• Exotropia is a common ocular misalignment.
• Cerebral palsy (CP) can be associated with various neurological and motor impairments, potentially affecting surgical outcomes.
• Understanding surgical success rates in exotropia patients with CP is crucial for effective management.

Purpose of the Study:

• To compare the surgical outcomes of exotropia patients with cerebral palsy (CP) to age-matched controls without CP.
• To evaluate the efficacy of bilateral lateral rectus (BLR) recession in correcting exotropia in both groups.

Main Methods:

• Retrospective enrollment of 30 exotropia patients with CP and 60 age-matched controls without CP.
• All patients underwent bilateral lateral rectus (BLR) recession using Parks' method.
• Surgical success defined as ≤5 PD esotropia or ≤10 PD exotropia; success rates and deviation changes analyzed using linear mixed models.

Main Results:

• Mean follow-up was over 21 months for CP group and 25 months for controls.
• Postoperative deviations were successfully reduced in both groups, with mean final deviations within the success range.
• Successful surgical outcomes were achieved in 76.7% of the CP group and 56.7% of the control group, with no statistically significant difference in cumulative success probability.

Conclusions:

• Bilateral lateral rectus recession provides successful ocular alignment for exotropia patients with cerebral palsy.
• Surgical outcomes in CP patients with exotropia are comparable to those without CP after BLR recession.
• This suggests that BLR recession is an effective surgical option for exotropia in the context of cerebral palsy.