Eight-Year Outcomes of Bilateral Lateral Rectus Recessions versus Unilateral Recession-Resection in Childhood...

Area of Science:

• Ophthalmology
• Strabismus Surgery
• Pediatric Eye Care

Background:

• Childhood intermittent exotropia (IXT) is a common strabismus condition.
• Surgical management aims to improve binocular vision and alignment.
• Comparing different surgical techniques is crucial for optimizing long-term outcomes.

Purpose of the Study:

• To compare 8-year outcomes of bilateral lateral rectus recession (BLRc) versus unilateral recession-resection (R&R) for childhood IXT.
• To evaluate the long-term efficacy and safety of these surgical approaches.

Main Methods:

• An 8-year follow-up of a randomized controlled trial (RCT) involving 123 participants with basic-type IXT.
• Participants were children aged 3-11 years with specific exotropia and stereoacuity measurements.
• Outcomes assessed included surgical success, reoperation rates, and changes in alignment and stereoacuity.

Main Results:

• The cumulative probability of suboptimal surgical outcome by 8 years was 68% for BLRc versus 53% for R&R (P=0.08).
• Complete or near-complete resolution at 8 years was achieved in 15% of BLRc patients compared to 37% of R&R patients (P=0.049).
• The cumulative reoperation rate was significantly higher for BLRc (30%) than for R&R (11%) (P=0.049).

Conclusions:

• While the primary outcome showed no statistically significant difference, secondary outcomes favored R&R.
• Unilateral R&R may offer better long-term results than BLRc for basic-type childhood IXT.
• Further investigation into surgical dosing and long-term management strategies is warranted.