Comparative study of lateral rectus recession versus recession-resection in unilateral surgery for intermittent exotropia

Abstract

To compare the outcomes of unilateral lateral rectus recession to unilateral recession-resection in the treatment of patients with intermittent exotropia. The medical records of patients with intermittent exotropia with exodeviation of 20(Δ) to 25(Δ) who underwent unilateral lateral rectus recession or recession-resection at a single center from 2002 to 2010 were retrospectively reviewed, and surgical outcomes between groups were compared. Of 70 patients, 37 underwent lateral rectus recession; 33, recession-resection. The mean preoperative exodeviation was 22.2(Δ) ± 2.1(Δ) at distance and 22.3(Δ) ± 3.3(Δ) at near in the lateral rectus group and 24.5(Δ) ± 1.4(Δ) at distance and 26.4(Δ) ± 3.6(Δ) at near in the recession-resection group. Successful surgical outcome was defined as esodeviation of ≤5(Δ) to exodeviation of ≤10(Δ) at distance in primary position. The mean follow-up period was 37.1 months in the lateral rectus group and 44.6 months in the recession-resection group (P = 0.078). The surgical success did not differ significantly between groups at the final follow-up (45.9% in the lateral rectus group and 39.4% in the recession-resection group; P = 0.215). However, posteroperative overcorrection was less common in the lateral rectus group through 12 months' follow-up. Surgical outcomes at a mean of 3.4 years did not differ significantly between groups. In our study cohort, unilateral lateral rectus recession showed a low risk of overcorrection in the treatment of mild to moderate angle exotropia.