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Comparison of Long-term Surgical Outcomes Between Unilateral Recession and Unilateral Recession-Resection in
Hyuna Kim1, Hee Kyung Yang1, Jeong-Min Hwang1
1Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
Insights
Unilateral lateral rectus recession-medial rectus resection (RR) surgery offers better long-term alignment and lower recurrence rates for intermittent exotropia than unilateral lateral rectus recession (ULR). This finding is crucial for pediatric strabismus treatment.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Strabismus Surgery
Background:
- Intermittent exotropia is a common form of strabismus in children.
- Surgical management aims to restore binocular vision and improve ocular alignment.
- Choosing the appropriate surgical technique is critical for successful outcomes.
Purpose of the Study:
- To compare the surgical outcomes of unilateral lateral rectus recession-medial rectus resection (RR) versus unilateral lateral rectus recession (ULR).
- To evaluate success rates, recurrence, and overcorrection in children with intermittent exotropia of ≤20 prism diopters (PD).
Main Methods:
- Retrospective, nonrandomized clinical study of 130 children with intermittent exotropia (≤20 PD).
- Patients underwent either unilateral RR or ULR (10 mm).
- Minimum follow-up of 2 years, assessing ocular alignment, recurrence, and overcorrection.
Main Results:
- The unilateral RR group showed significantly lower recurrence rates (30% vs. 59%) at a mean 3-year follow-up.
- Initial success rates at 6 months favored ULR (78% vs. 61%), but became comparable by 2 years.
- Overcorrection rates were similar between the two groups (8% vs. 3%).
Conclusions:
- Unilateral RR demonstrates superior long-term ocular alignment and reduced recurrence compared to ULR for small-angle intermittent exotropia (≤20 PD).
- RR may be a more effective surgical approach for achieving sustained correction in this patient population.
Purpose:
To compare the surgical outcomes of unilateral lateral rectus recession-medial rectus resection (RR) and unilateral lateral rectus recession (ULR) for intermittent exotropia of ≤20 prism diopters (PD).
Design:
Retrospective, nonrandomized clinical study.
Methods:
A total of 130 children with intermittent exotropia of ≤20 PD who underwent unilateral RR or ULR of 10 mm were included. Patients were observed for at least 2 years. Success rates, cumulative probabilities of success, and factors related to recurrence and overcorrection were evaluated.
Results:
The mean follow-up duration after surgery was 3.1 ± 1.0 years in the RR group and 3.6 ± 1.6 years in the ULR group. In the RR group, 38 of 61 patients (62%) had ocular alignment within 10 PD of exophoria/tropia and 5 PD of esophoria/tropia; 18 patients (30%) had recurrence, and 5 (8%) had overcorrection. In the ULR group, 26 of 69 patients (38%) had successful alignment, 41 patients (59%) had recurrence, and 2 patients (3%) were overcorrected. At 6 months after surgery, the success rate was significantly higher in the ULR group (RR 61%; ULR 78%, P = .039), but it became comparable after 2 years (RR 60%; ULR 52%, P = .370). At the final examination after a mean duration of 3 years, the recurrence rates were lower in the RR group (30% vs 59%, P = .001), and the overcorrection rates were comparable (8% vs 3%, P = .252).
Conclusion:
Unilateral RR resulted in more successful alignment and lower recurrence compared to ULR for the treatment of small-angle intermittent exotropia of ≤20 PD.
