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Scleral Cross-linking Using Riboflavin and Ultraviolet-A Radiation for Prevention of Axial Myopia in a Rabbit Model

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Long-term Outcomes of Bilateral Lateral Rectus Recession Using a Modified Normogram for Targeting Small

Sanghyuk Ahn¹, Daniel Jinhag Baik¹, Seung-Hyun Kim¹

¹Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea.

Korean Journal of Ophthalmology : KJO

|August 22, 2024

Summary

A modified surgical approach for intermittent exotropia achieved a high success rate with minimal overcorrection. This method reduces the risk of consecutive esotropia in patients undergoing bilateral lateral rectus recession.

Keywords:

Esotropia Exotropia Strabismus

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Published on: September 20, 2024

Area of Science:

Ophthalmology
Surgical Techniques
Strabismus Management

Background:

Intermittent exotropia is a common strabismus condition requiring surgical intervention.
Achieving optimal surgical outcomes involves balancing correction of the outward deviation with minimizing overcorrection (esotropia).
Traditional surgical norms may lead to undesirable overcorrection or undercorrection.

Purpose of the Study:

To evaluate the efficacy of a modified surgical normogram for bilateral lateral rectus recession in treating intermittent exotropia.
To assess the rate of small postoperative overcorrection achieved with the modified approach.

Main Methods:

Retrospective chart review of 242 patients with intermittent exotropia undergoing surgery.
Application of a modified normogram targeting small postoperative overcorrection (within 5 prism diopters).
Long-term follow-up (at least 3 years) to assess outcomes, recurrence, and overcorrection rates.

Main Results:

The modified normogram resulted in a long-term success rate of 83.06% after a mean follow-up of 38.6 months.
Early postoperative overcorrection (within 6 PD) was observed in 69.42% of patients.
The 3-year recurrence rate was 19.83%, and the overcorrection rate was 2.89%.

Conclusions:

The modified normogram for bilateral lateral rectus recession is effective in managing intermittent exotropia.
This approach successfully achieves small overcorrections, mitigating the risk of consecutive esotropia.
The study demonstrates a favorable balance between efficacy and safety in surgical management.