Surgical outcomes according to distance between preplaced suture and muscle insertion in lateral rectus recession

To compare surgical outcomes according to the distance between the preplaced suture and the muscle insertion in lateral rectus (LR) recession for exotropia.

We retrospectively reviewed 64 patients who had undergone unilateral LR recession by one right-handed surgeon and divided the patients into 2 groups: right LR recession (R group, 26 patients) and left LR recession (L group, 38 patients). In the R group, the preplaced suture was behind the hook, far from the insertion; in the L group, the suture was in front of the hook, near the insertion. The main outcome measures were postoperative alignment and surgical success rate and the secondary outcome measure was effect/dose ratio. Surgical success was defined as an alignment between 10 prism diopters (PD) of exodeviation and 5 PD of esodeviation both at distance and at near. The effect/dose ratio was defined as the corrected angle of deviation at postoperative 6 months divided by the amount of LR recession.

The mean angle of deviation at distance showed a significant difference between the groups at postoperative 3 months (p = 0.022), but not at final follow-up (p = 0.163). There was no difference between the groups in the mean angle of deviation at near postoperatively. Surgical success was achieved in 73.1% of the R group and 71.1% of the L group at final follow-up, which was not significant (p = 0.860).

The distance between the preplaced suture and the muscle insertion in LR recession did not affect the surgical success rate or the postoperative alignment at final follow-up.