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Plication versus Resection in Horizontal Strabismus Surgery: A Systematic Review with Meta-Analysis.
Dayane Cristine Issaho1,2,3, Denise de Freitas2,3, Monica Fialho Cronemberger2,3
1Hospital de Olhos Do Parana, Curitiba, Brazil.
Journal of Ophthalmology
|July 28, 2020
Summary
Rectus muscle plication and resection show similar efficacy for horizontal strabismus surgery. Both techniques can lead to exodrift, highlighting the need for further randomized trials to compare long-term outcomes.
Area of Science:
- Ophthalmology
- Surgical Techniques
- Strabismus Management
Background:
- Horizontal strabismus affects ocular alignment.
- Surgical correction often involves rectus muscle manipulation.
- Plication and resection are two common surgical approaches.
Purpose of the Study:
- To compare the efficacy of rectus muscle plication versus resection in treating horizontal strabismus.
- To evaluate the incidence and impact of exodrift following each surgical technique.
Main Methods:
- Systematic review of studies from LILACS, MEDLINE, and CENTRAL databases.
- Inclusion of studies with a minimum six-month follow-up.
- Definition of motor alignment success as postprocedure deviation within 10 prism diopters (PD) of orthotropia.
Main Results:
- Seven studies were included in the analysis.
- Grouped success rates were 66% for plication and 68% for resection (95% CI [43%-89%]).
- No significant difference was found in the mean deviation corrected (SMD = 0.12; p=0.45) or undercorrection rates (OR = 1.37; p=0.462).
Conclusions:
- Rectus muscle plication is a viable alternative to resection for strabismus surgery, yielding comparable outcomes.
- Exodrift is a potential complication after both plication and resection in exotropia treatment.
- Further randomized clinical trials are needed to comprehensively compare long-term follow-up results.
