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In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
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Surgical Dosing for V-Pattern Exotropia.

Veronika Yehezkeli1, Emanuil Parunakian2, Soh Youn Suh3

  • 1From the Stein Eye Institute and Department of Ophthalmology (V.Y., S.Y.S., Q.M., J.L.D.), University of California, Los Angeles, Los Angeles, California, USA.

American Journal of Ophthalmology
|August 14, 2025
PubMed
Summary
This summary is machine-generated.

Surgical strategies including inferior oblique recession and lateral rectus transposition effectively reduce V-pattern exotropia. Combining these procedures offers the greatest pattern reduction for VXT patients.

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Area of Science:

  • Ophthalmology
  • Strabismus Surgery
  • Pediatric Ophthalmology

Background:

  • Optimal surgical strategies for V-pattern exotropia (VXT) lack consensus.
  • VXT is a type of strabismus characterized by incomitance.

Purpose of the Study:

  • To quantitatively compare alternative surgical strategies for VXT.
  • To evaluate the effectiveness of different surgical approaches and their dosing.

Main Methods:

  • Comparative interventional case series of 55 VXT patients (2014-2025).
  • Surgical techniques included inferior oblique (IO) recession, superior transposition of lateral rectus muscles, or their combination.
  • Primary outcome was the surgical alignment effect and pattern reduction.

Main Results:

  • All surgical groups achieved significant reduction in primary gaze exotropia (29Δ to 8Δ).
  • The combination of IO recession and LR transposition yielded the greatest pattern reduction.
  • Horizontal rectus recession showed a significant correlation with exotropia reduction but was less effective than predicted.

Conclusions:

  • IO recession, LR transposition, and their combination are effective in reducing VXT pattern.
  • The combined procedure offers the most significant pattern reduction.
  • Early overcorrection is recommended for VXT surgery.