Related Experiment Video
Updated: Mar 7, 2026
Surgical Correction for Pediatric Epiblepharon and Trichiasis
Published on: July 8, 2025
Comparative study of plication-recession versus resection-recession in unilateral surgery for intermittent exotropia
1Kimura Eye and Internal Medicine Hospital, 3-15 Takaramachi, Kure, Hiroshima, 737-0029, Japan. ky.kimuraeye@gmail.com.
Purpose:
Plication is a muscle-strengthening procedure in which a muscle is not dissected from its point of insertion. The purpose of this study was to compare the results of plication-recession (PR) with those of resection-recession (RR) in adult patients with intermittent exotropia (XT).
Methods:
Patients with XT who underwent either PR or RR with a minimum postoperative follow-up of 12 months were retrospectively reviewed. Postoperative mean distance deviation and surgical outcomes were compared at 1 week and at 1, 3, 6, and 12 months, and at the final follow-up. A successful outcome was defined as esophoria or esotropia ≤5 PD (prism diopters) to exophoria or exotropia ≤10 PD.
Results:
Forty-five patients underwent PR and 43 underwent RR. The mean preoperative distance deviation was 40.1 ± 12.9 PD in the PR group and 40.0 ± 14.9 PD in the RR group (P = 0.96). Mean follow-up was 21.0 ± 7.6 months for PR and 24.0 ± 8.6 months for RR (P = 0.08). The mean postoperative distance deviation at 12 months was 8.3 ± 7.4 PD for PR and 9.9 ± 9.6 PD for RR (P = 0.38). PR had a significantly better outcome than RR at 1 week (PR 89%; RR 72%; P = 0.04), but there was no difference between PR and RR at 12 months (PR 67%; RR 60%; P = 0.50).
Conclusion:
PR and RR achieved comparable distance deviation and success rates at 12 months. PR had a better short-term success rate, and might prevent postoperative diplopia caused by overcorrection.
