Abstract
Plication is a muscle-strengthening procedure in which a muscle is not dissected from its point of insertion. The purpose of this study was to compare the results of plication-recession (PR) with those of resection-recession (RR) in adult patients with intermittent exotropia (XT). Patients with XT who underwent either PR or RR with a minimum postoperative follow-up of 12months were retrospectively reviewed. Postoperative mean distance deviation and surgical outcomes were compared at 1week and at 1, 3, 6, and 12months, and at the final follow-up. A successful outcome was defined as esophoria or esotropia ≤5 PD (prism diopters) to exophoria or exotropia ≤10 PD. Forty-five patients underwent PR and 43 underwent RR. The mean preoperative distance deviation was 40.1±12.9 PD in the PR group and 40.0±14.9 PD in the RR group (P=0.96). Mean follow-up was 21.0±7.6months for PR and 24.0±8.6months for RR (P=0.08). The mean postoperative distance deviation at 12months was 8.3±7.4 PD for PR and 9.9±9.6 PD for RR (P=0.38). PR had a significantly better outcome than RR at 1week (PR 89%; RR 72%; P=0.04), but there was no difference between PR and RR at 12months (PR 67%; RR 60%; P=0.50). PR and RR achieved comparable distance deviation and success rates at 12months. PR had a better short-term success rate, and might prevent postoperative diplopia caused by overcorrection.
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