Bilateral lateral rectus recession versus unilateral recession resection for basic intermittent exotropia: a meta-analysis.

Abstract

To compare the outcomes between bilateral lateral rectus recession (BLR) and unilateral recession resection (R&R) procedures in the treatment of basic intermittent exotropia. Databases from Medline, Embase, Web of Science and the Cochrane Register of Controlled Trials were searched prior to June 2, 2017. From these searches, three eligible randomized studies and three retrospective cohort trials, which compared conventional BLR versus R&R procedure were identified. Differences observed between these two interventions (BLR versus R&R) were expressed as odds ratio (OR) and 95% confidence intervals (CI). The data on rates of success, recurrence, and overcorrection were pooled and analyzed using a random-effects model. Our findings, as generated from the pooled estimates, suggested that success rates for the R&R procedure were significantly greater than that of BLR (OR, 0.50; 95% CI, 0.31-0.79; P = 0.003) and patients subjected to the BLR procedure were more likely to be recurrent (OR, 2.44; 95% CI, 1.17-5.10; P = 0.02). No statistically significant differences in the combined results for overcorrection rates were present between the BLR and R&R procedures (OR, 0.85; 95% CI, 0.32-2.28; P = 0.75). The overall findings from this meta-analysis indicated that the conventional R&R procedure is associated with higher success rates and lower recurrence rates in patients with basic intermittent exotropia.