Surgical outcomes of plication versus resection in basic type of intermittent exotropia

Abstract

ObjectivesTo compare the surgical outcomes of plication versus resection in basic type of intermittent exotropia. DesignProspective interventional study. Participants60 patients above 6 years of age with diagnosis of basic type of intermittent exotropia. MethodsA randomized study was conducted in 60 patients above 6 years of age with diagnosis of basic type of intermittent exotropia. They were equally divided in two groups by computer generated random number table. Group A underwent recession and plication (RP) and group B underwent recession and resection (RR) based on post patch deviation with constant 8 mm lateral rectus recession in both groups. Parameters assessed were postoperative alignment, cosmetic outcome, improvement in binocularity & stereoacuity and dose effect. Successful outcome was defined as post patch deviation ≤ 10 Prism diopters (PD) of exophoria/exotropia to < 5 PD of esophoria/esotropia at 12 months follow up. ResultsThe mean preoperative and postoperative deviation was 44.67 ± 4.5 PD and 10.13 ± 3.6 PD respectively in group A and 43.17 ± 4.8 PD and 9.40 ± 3.3 PD respectively in group B (p = 0.423). The exodrift at 12 months follow up was 4.4 ± 2.8 PD in group A and 4.67 ± 3.29 PD in group B. There was statistically no significant difference in outcomes between the two groups. Mean effect of MR plication at last follow up was 5.91 PD/mm and MR resection was 5.5 PD/mm (p = 0.877). ConclusionBoth procedures achieved acceptable ocular alignment and had a comparable dose effect. Plication has certain added advantages over resection hence may be preferred as an alternate tightening procedure.