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Treatment of intermittent exotropia in children using a lateral rectus fenestration technique
Mohamed Elkhawaga1, Ahmed Kassem1, Amr Elkamshoushy1
1Ophthalmology Department, Alexandria University, Alexandria, Egypt.
Insights
Bilateral lateral rectus muscle fenestration effectively treated intermittent exotropia in children, significantly reducing eye deviation. This surgical approach achieved successful outcomes in 81% of pediatric patients, with no complications reported.
Area of Science:
- Ophthalmology
- Pediatric Strabismus Surgery
Background:
- Intermittent exotropia is a common form of strabismus in children.
- Surgical intervention is often necessary to correct significant deviations and improve binocular function.
Purpose of the Study:
- To evaluate the efficacy of bilateral fenestration of the lateral rectus muscle for treating intermittent exotropia in pediatric patients.
- To assess the degree of alignment correction and complication rates associated with this surgical technique.
Main Methods:
- Prospective enrollment of 36 children under 12 years with basic or pseudo-divergence excess intermittent exotropia.
- Surgical procedure involved bilateral fenestration of the lateral rectus muscles.
- Success defined as postoperative alignment within 8 prism diopters (Δ) of orthotropia at the last follow-up.
Main Results:
- Mean preoperative distance deviation of 33.1Δ reduced to 4.5Δ postoperatively (P < 0.001).
- Mean preoperative near deviation of 32.0Δ reduced to 2.8Δ postoperatively (P < 0.001).
- Successful outcomes achieved in 81% of patients at 6-month follow-up; no intra- or postoperative complications were reported.
Conclusions:
- Bilateral lateral rectus muscle fenestration is a safe and effective surgical option for pediatric intermittent exotropia.
- The procedure leads to significant and sustained reduction in the angle of deviation.
- High success rates and absence of complications support its use in managing this condition.
Purpose:
To report the results of bilateral fenestration of the lateral rectus muscle in cases of intermittent exotropia in pediatric patients.
Methods:
Children <12 years of age with basic and pseudo-divergence excess type intermittent exotropia who underwent bilateral lateral rectus muscle fenestration were prospectively enrolled in this study. Success was defined as postoperative alignment within 8Δ of orthotropia in the primary position at the last follow-up.
Results:
A total of 36 children were included. The mean preoperative angle of deviation at distance improved from 33.1Δ ± 3.8Δ (range, 25Δ-40Δ) preoperatively to 4.5Δ ± 5.7Δ (range, 0-16Δ) postoperatively (P < 0.001). The near angle was reduced from 32.0Δ ± 4.2Δ (range, 25Δ-35Δ) to 2.8Δ ± 4.5Δ (range, 0Δ-14 Δ) postoperatively (P < 0.001). Successful outcome was achieved in 81% of the cases at the 6-month follow-up. There were no reported intra- or postoperative complications.
Conclusions:
In our study cohort, bilateral fenestration of the lateral rectus muscle resulted in successful outcomes in the majority of patients, resulting in a significant reduction in angle of deviation in primary position at both distance and near fixation.
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