Clinical evidence for an accessible modification to the Scott resection-recession procedure, using a matching duction technique

Abstract

To evaluate the resection-recession procedure on a single muscle for the management of incomitant strabismus using an alternative calculation. The medical records of adult patients undergoing combined adjustable resection-recession surgery on a single rectus muscle at one institution from 2008 to 2019 were reviewed retrospectively. Each patient had a full orthoptic evaluation before and at least 10weeks after surgery. The main outcome measure was alignment at last follow-up examination in the primary position and eccentric gaze (field of action). A total of 20 procedures in 20 patients were included. The etiology was paretic in 14 cases and restrictive in 6. All rectus muscles were operated. An adjustable suture technique was used in every case, but only 5 required adjustment. The average length of follow-up was 1.7years (range, 2.4months to 11.1years). Postoperative reduction of deviation in eccentric gaze was observed in all patients and averaged 70% (range, 5Δ-48Δ). The technique was particularly helpful for the inferior rectus muscle (85.8% reduction), followed by the medial rectus (66%), lateral rectus (55%), and superior rectus muscles (55%). Three-quarters of the patients became orthotropic in primary position. Good results were noted for both paretic and restrictive etiologies (64%, 83%, resp., reduction in eccentric gaze). Four of 20 patients (20%) were overcorrected in eccentric gaze. One patient required prism to control a small comitant deviation (6Δ). No complications or muscle slippage occurred. In our study cohort, the resection-recession operation was effective in reducing incomitance when used on any of the four rectus muscles.