Bilateral lateral rectus recession versus unilateral recession/resection for basic intermittent exotropia

Area of Science:

• Ophthalmology
• Surgical Techniques
• Evidence-Based Medicine

Background:

• Intermittent exotropia often necessitates surgical intervention.
• Key surgical options include bilateral lateral rectus recession and unilateral recess/resection.
• The comparative effectiveness of these techniques is not definitively established.

Purpose of the Study:

• To compare the surgical success rates of bilateral lateral rectus recession versus unilateral recess/resection for intermittent exotropia.
• To evaluate the impact of each surgical technique on undercorrection and recurrence rates.

Main Methods:

• A comprehensive systematic review was conducted using the Epistemonikos database.
• Data were extracted from existing systematic reviews and reanalyzed from primary studies.
• A meta-analysis and GRADE assessment were performed to synthesize findings.

Main Results:

• Five systematic reviews, encompassing seven studies (including three randomized trials), were identified.
• Unilateral recess/resection demonstrated potentially higher surgical success.
• This technique may also lead to a lower incidence of undercorrection or recurrence.

Conclusions:

• Unilateral recess/resection appears to be a more effective surgical approach for intermittent exotropia compared to bilateral lateral rectus recession.
• This method may offer improved long-term outcomes by reducing the likelihood of undercorrection and recurrence.