Effects of Bilateral Medial Rectus Resection on Motor Outcomes in Infantile Exotropia
Teiji Yagasaki1,2, Yoshimi Yokoyama2, Ayaka Yagasaki2,3
1Yagasaki Eye Clinic, Ichinomiya, Aichi, Japan.
Insights
Bilateral medial rectus resection (BMRres) surgery offers superior motor outcomes for infantile exotropia compared to other surgical methods. This procedure demonstrates better long-term results in managing this condition.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Strabismus Surgery
Background:
- Infantile exotropia is a common form of strabismus in children.
- Surgical management aims to restore binocular vision and alignment.
- Various surgical techniques exist, each with potential benefits and drawbacks.
Purpose of the Study:
- To evaluate the efficacy of bilateral medial rectus resection (BMRres) in improving motor outcomes for infantile exotropia.
- To compare the outcomes of BMRres with other surgical procedures for this condition.
Main Methods:
- A retrospective study of 19 infantile exotropia cases undergoing surgery.
- Patients were divided into a BMRres group (n=8) and an 'other' surgical procedures group (n=11).
- Surgical outcomes were assessed at 1 day, and 1, 3, and 6 months post-operation, defining success, recurrence, and overcorrection.
Main Results:
- While initial deviations were similar, the BMRres group showed significantly smaller deviations at 1, 3, and 6 months post-surgery.
- Success rates at 6 months were 88% for BMRres versus 18% for other procedures.
- BMRres demonstrated significantly better surgical outcomes at 6 months compared to other methods (p=0.003).
Conclusions:
- Bilateral medial rectus resection (BMRres) is a more effective surgical approach for infantile exotropia.
- BMRres leads to more desirable and sustained motor outcomes compared to alternative surgical techniques.
Purpose:
To evaluate the effects of bilateral medial rectus resection (BMRres) on motor outcomes in infantile exotropia.
Methods:
We evaluated 19 cases of infantile exotropia surgery. The mean age at surgical alignment was 4.8±3.4 years (range, 1.5-11.8 years). The surgical procedures included BMRres (5 cases), BMRres with unilateral lateral rectus recession (ULRR) (3 cases), bilateral lateral rectus recession (BLRR) (8 cases), unilateral lateral rectus recession and medial rectus resection (uniRandR) with contralateral lateral rectus recession (2 cases), and uniRandR (1 case). After dividing the cases into two groups (BMRres group, n=8; other group, n=11), the outcomes at 1 day and at 1, 3, and 6 months after surgery were compared. Surgical outcomes were defined as (1) success: distant esotropia ≤5 prism diopters (Δ) or exotropia ≤10Δ, (2) recurrence: exotropia >10Δ, or (3) overcorrection: esotropia >5Δ.
Results:
Although postoperative distant deviations at 1 day were not different between the two groups, the BMRres group showed smaller distant deviations at 1, 3, and 6 months than the other group (p=0.015, 0.019, and 0.006, respectively). Success rates of the BMRres and other groups were 88% and 73% at 1 day, 100% and 36% at 1 month, 88% and 27% at 3 months, 88% and 18% at 6 months, respectively. Although there were no significant differences between the two groups within 3 months after surgery, surgical outcomes in the BMRres group 6 months after surgery were significantly better than those in the other group (p=0.003).
Conclusion:
BMRres is a better procedure than others for infantile exotropia to achieve desirable motor outcomes after surgery.
More Related Videos
05:56Scleral Cross-linking Using Riboflavin and Ultraviolet-A Radiation for Prevention of Axial Myopia in a Rabbit Model
Published on: April 3, 2016
13:12Partial Optic Nerve Transection in Rats: A Model Established with a New Operative Approach to Assess Secondary Degeneration of Retinal Ganglion Cells
Published on: October 15, 2017
Related Concept Videos
01:20Muscles of the Eye
Extraocular Muscles
The six extraocular muscles surround the eyeball and control its movements. They are responsible for a wide range of eye motions, including looking up, down, left, right, and...
01:17Accessory Structures of the Eye