Unilateral lateral rectus recession is an effective surgery for intermittent exotropia in young children

Oriel Spierer,Abraham Spierer

doi:10.1186/s12886-020-01778-2

Abstract

BackgroundDifferent surgical methods have been suggested for the correction of intermittent exotropia. Unilateral lateral rectus recession has been described as a surgical alternative for small and moderate-angle exotropia. In general, previous studies did not focus on the outcomes of unilateral lateral rectus recession in young children with intermittent exotropia. The purpose of this study is to evaluate the surgical outcomes of unilateral lateral rectus recession in the treatment of moderate-angle exotropia (≤ 25 PD (prism diopters)) in children.MethodsThe charts of all patients younger than 12 years of age with moderate-angle exotropia (up to 25 PD) who were operated during the years 2006–2018 were retrospectively reviewed. Fifty-eight patients underwent unilateral lateral rectus recession and had a minimum follow up of 6 months. The angle of exotropia (PD) before and after surgery and the success rate were documented.ResultsMean age at surgery was 6.4 ± 1.9 (range 3.5–11.0) years. Exotropia improved from a preoperative angle of 21.4 ± 4.0 PD to 3.5 ± 5.9 PD postoperatively (p < 0.001). Success rate, defined as deviation of ≤ 10 PD, was achieved in 86.2%. There were 2 (3.4%) cases of overcorrection (consecutive esotropia). There were no intra- or postoperative complications. The mean follow-up duration after surgery was 2.3 ± 1.7 years.ConclusionsIn children with moderate angle exotropia, good postoperative success rate was achieved by performing unilateral lateral rectus recession.

Highlights

Different surgical methods have been suggested for the correction of intermittent exotropia
Many investigators [4,5,6,7] agree that unilateral lateral rectus recession may be effective in exotropia of 15–20 Prism diopters (PD), reporting surgical success rate ranging from 72–90% in these angles [4,5,6,7,8,9,10,11]
A concern in unilateral lateral rectus recession is postoperative lateral incomitance. This concern was ruled out in some studies, [5,6,7] and in others it was verified only when the lateral rectus muscle was recessed more than 9 mm [6, 8].In our previous study [9] we have found that unilateral lateral rectus recession may be as effective as bilateral lateral rectus recession in the treatment of patients with exotropia

Summary

Introduction

Different surgical methods have been suggested for the correction of intermittent exotropia. The purpose of this study is to evaluate the surgical outcomes of unilateral lateral rectus recession in the treatment of moderate-angle exotropia (≤ 25 PD (prism diopters)) in children. Bilateral lateral rectus recession and recession of the lateral rectus with resection of the medial rectus muscles in one eye are the most encountered methods [1]. While these types of surgery are the most abundant among. A recent study comparing between unilateral lateral rectus surgery and lateral rectus recession combined with medial rectus resection for the treatment of intermittent exotropia reported

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