Abstract
Purpose The purpose of this review was to compare the efficacy of rectus muscle plication versus resection on the treatment of horizontal strabismus and to evaluate the exodrift after each technique. Methods A research was performed in Latin American and Caribbean Literature on Health Sciences (LILACS); MEDLINE; and Cochrane Central Register of Controlled Trial (CENTRAL). The database was searched by 30 June 2019. The selection was restricted to articles published in English, Spanish, or Portuguese. There were no date restrictions in the search. A minimum mean follow-up of six months was required to access the primary outcomes. Motor alignment success was defined as postprocedure deviation within 10 prism diopters (PD) of orthotropia. Results Seven studies were eligible for inclusion. The grouped success rate after plication was 66% (95% CI = [43%–89%]), and the grouped success rate after resection was 68% (95% CI = [43%–89%]). High heterogeneity was observed between the estimations. There was no difference between the mean amount of deviation corrected in prism diopters, when using the mixed-model approach (SMD = 0.12; 95% CI = −0.2–0.44; p=0.45). The undercorrection rates were also analyzed. The combined odds ratio was 1.37 (95% CI = 0.59–3.16; p=0.462), and there was no statistical significance. Conclusion Plication of horizontal extraocular muscles reveals to be an alternative to resection in strabismus surgery, with similar results. Exodrift is observed after plication and after resection in the treatment of exotropia, but randomized clinical trials are necessary to analyze and compare the follow-up.
Highlights
Resection is a traditional muscle-tightening procedure in strabismus surgery in which the muscle is disinserted from the globe and it is shortened
Eligibility Criteria. e criteria for considering studies for this review were as follows: studies analyzing neurologically normal patients with horizontal strabismus; minimum mean follow-up of 6 months; rectus muscle plication or resection performed during strabismus surgery; and criteria of success postoperative deviation within 10 prism diopters (PD) in primary position
We considered the groups separately
Summary
Resection is a traditional muscle-tightening procedure in strabismus surgery in which the muscle is disinserted from the globe and it is shortened. Several other advantages of plication have been described in the previous studies, including the absent risk of lost muscle, the possibility of early reversibility, and its relative simplicity and short operating time, as the prospect of less surgical trauma, inflammation, and hemorrhage than resection procedures [7,8,9]. There is no consensus on performing muscle-to-sclera plication or resection in the treatment of horizontal strabismus. E main purposes of this study were to compare the efficacy of rectus muscle plication versus resection on the treatment of horizontal strabismus and to evaluate the average exodrift after surgery with each technique
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