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Comparison of plication and resection in large-angle exotropia
Jaspreet Sukhija1, Savleen Kaur1
1Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Summary
Medial rectus plication and resection yield similar outcomes for exotropia. Ultrasound biomicroscopy (UBM) effectively quantifies plication, offering a measurable advantage for this strabismus surgery technique.
Area of Science:
- Ophthalmology
- Surgical Techniques
- Strabismus Surgery
Background:
- Rectus muscle plication is less common than resection for strabismus tightening.
- Limited comparative data and lack of imaging hinder assessment of plication vs. resection efficacy.
- This study compares plication and resection for exotropia using ultrasound biomicroscopy (UBM).
Purpose of the Study:
- To compare the efficacy of medial rectus plication versus resection in patients with exotropia.
- To quantitatively assess surgical outcomes using ultrasound biomicroscopy (UBM).
Main Methods:
- Prospective case series of 28 patients with exotropia (30-50 prism diopters) undergoing first-time horizontal strabismus surgery.
- Medial rectus plication involved folding and suturing the muscle; resection was performed conventionally.
- Ultrasound biomicroscopy (UBM) was used for quantitative assessment one year post-surgery.
Main Results:
- No significant difference in postoperative deviation or abduction limitation between plication (13 patients) and resection (15 patients) groups.
- UBM accurately identified and quantified plication, showing excellent agreement with operative data (ICC=0.886).
Conclusions:
- Medial rectus plication and resection provide similar functional outcomes for exotropia of similar magnitudes.
- Plication is uniquely identifiable and measurable using ultrasound biomicroscopy (UBM).
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