Lateral Rectus Recession Group Research Articles

Surgical management of consecutive exotropia: Long-term outcomes.

To compare lateral rectus recession (LRc) and medial rectus advancement (MRadv) for correction of consecutive exotropia (CXT). Of the 43 exotropic patients 20 of them underwent LRc (group 1) and 23 of them underwent MRadv (group 2). Postoperative exodrift, strabismic angle, dose effect relationship were compared with minimum 2 years follow‑up. An average dose-effect in group 2 is higher than group 1 in the early postoperative period, however there was no significant difference at the second year follow-up (p=0,109). An average exodrift after 2 year follow-up was 6,6±7,12 PD in group 1, and 8,13±7,45 PD in group 2. Postoperative overall success rate was 50% in group 1 and 65% in group 2 at the last follow-up. The success rates were not significantly different between the groups (chi-square, p =0.31). Although there was no statistically significant difference at the last follow-up, better results were obtained with MRadv than LRc in the treatment of CXT.

The use of one muscle recession for horizontal strabismus

PurposeTo evaluate the outcomes of one muscle recession for horizontal comitant strabismus at a major referral hospital in the Middle East. MethodRetrospective charts review of postoperative outcomes of 90 patients who had undergone one muscle recession for small to moderate angle esotropia or exotropia. Data were collected for age, vision, amblyopia, previous surgery or botulinum toxin injection, preoperative deviation, amount and type of one muscle surgery, and postoperative deviation at the initial and last (six months or more) postoperative visit. Successful alignment was defined as ±10 prism diopters (PD) of orthophoria. ResultsSixty patients underwent medial rectus recession and 30 patients underwent lateral rectus recession. The average preoperative and last follow up deviation -respectively- was 24 ± 6.1 PD (15–35) PD and 14.62 ± 8.91 PD in the medial rectus recession group and 21.3 ± 5.1 PD (12–30) and 12.60 ± 8.74 in the lateral rectus recession group. The final success rates were 63.3% in both groups. ConclusionSingle muscle strabismus surgery to correct horizontal strabismus had a variable outcome. Larger recession may help in achieving better outcomes. Properly designed prospective studies may help in identifying the factors affecting the outcomes of single muscle strabismus surgeries.

Changes in lateral ocular movement after two muscle exotropia surgery

Objective This study was to identify the surgical procedures associated with changes of lateral eye movement to help inform surgical planning for patients with concomitant exotropia. Methods The medical records of 87 concomitant exotropia surgical procedures that were performed at Henan Eye Hospital from June 2014 to August 2015 were retrospectively reviewed.The deviation angle was measured by prism and alternate cover test.Photographs and arc campimeter was used to obtain changes of abduction and lateral monocular fixation field respectively.Data were compared preoperatively and postoperatively among five groups based on the surgical procedures.The surgical procedures were 0 mm for control group (61 eyes), 8 mm unilateral rectus recession for lateral rectus recession (LR) group (27 eyes), 5-6 mm recession/4-5 mm resection for small amount recess-resect (R-R) group (24 eyes), 7-8 mm recession/5-6 mm resection for medium amount R-R group (29 eyes) and 8-10 mm recession/7-8 mm resection for large amount R-R group (33 eyes). The minimum follow-up period was 6 months.Informed consent was signed from each patient or the guardian. Results The success, overcorrection and undercorrection rate was 81.61%, 5.56% and 12.64%, respectively.Mean preoperative abduction of each group was (11.86±1.11)mm in the control group, (12.04±0.68)mm in the LR group, (11.58±1.06)mm in the small amount R-R group, (11.86±0.93)mm in the medium amount R-R group and (12.22±0.60)mm in the large amount R-R group.The postoperative mean abduction of each group was (11.81±1.03), (11.81±0.70), (10.78±1.05), (10.54±1.07) and (9.90±0.82)mm, respectively.Mean abduction among the five groups was not significantly different preoperatively (F=1.85, P=0.12), while it was significantly different postoperatively (F=28.04, P=0.00). The abduction between control group and small amount R-R group was not significantly different postoperatively (P=0.99), but the abduction of control group was significantly greater than that of all the R-R groups (all at P=0.00). Mean lateral monocular fixation field of each group preoperatively was (50.82±3.30)° in control group, (51.48±2.39)° in LR group, (50.13±3.51)° in small amount R-R group, (51.06±2.90)° in medium amount R-R group and (52.09±2.61)° in large amount R-R group.The postoperative mean lateral monocular fixation field of each group was (50.52±3.51)°, (50.11±2.36)°, (46.38±3.67)°, (44.00±3.00)°, (41.84±2.46)°, respectively.Preoperative lateral monocular fixation field among the five groups was not significantly different (F=1.75, P=0.14), while postoperative difference was significant (F=55.75, P=0.00). Lateral monocular fixation field between control group and LR group was not significantly different postoperatively (P=0.57), but the mean lateral monocular fixation field of control group was significantly greater than that of all the R-R groups (all at P=0.00). Conclusions The successful alignment rate of unilateral recess/resect procedure is satisfying, but it can also create abduction deficit especially in large surgical amounts eye.Patients with binocular vision will be sensitive to diplopia in side gaze; in such cases, the consequences of recess/resect procedure should be considered particularly to avoid decrease of the binocular single vision field. Key words: Exotropia, concomitant/surgery; Ocular movement/Abduction; Stereopsis; Monocular vision field; Treatment outcomes

Quantitative measurement of retinal vascular diameter changes in the early postoperative period after strabismus surgery

To investigate quantitatively the retinal vascular diameter changes before and after strabismus surgery, analyzing the potential hemodynamic changes that may occur in the retinal circulation. Consecutive patients with horizontal strabismus who underwent strabismus surgery were prospectively enrolled. Color fundus photographs were taken of each eye before and 1day after surgery. The retinal vessel diameters were measured using computer-assisted quantitative assessment software. Paired-sample t test was used to evaluate the central retinal arteriolar equivalent (CRAE), central retinal venular equivalent (CRVE), and arteriovenous ratio (AVR) before and 1day after surgery. We also analyzed those changes in different subgroups according to surgical protocols. A total of 217 eyes of 148 patients were included. Compared with the data before surgery, the mean CRAE significantly increased 1day after surgery (P=0.01), so did the AVR (P=0.003). There was no significant difference with respect to CRVE (P=0.43). The CRAE and AVR were not significantly different in the lateral rectus recession group. Strabismus surgery on horizontal rectus muscles may change retinal hemodynamics by increasing the central retinal arteriolar diameter during the early postoperative period.

Surgical results for consecutive exotropia.

PURPOSE:To evaluate the surgical results of medial rectus (MR) muscle advancement with or without recession of the antagonist muscle for consecutive exotropia.METHODS:Medical records of patients with consecutive exotropia (n = 27) were retrospectively reviewed. All patients received one-eye surgery with MR advancement, lateral rectus (LR) recession, or combined surgery. The pre- and post-operative angle of deviation was recorded. Characteristics were compared between groups. The follow-up period was at least 3 months.RESULTS:The overall successful rate was 62.96%, with 50% in MR advancement group, 60% in LR recession group, and 71.4% in combined group. Patients in combined group had larger preoperative deviation. There were comparable surgical results between patients with inferior oblique (IO) muscle overaction receiving correction simultaneously and patients without IO muscle overaction.CONCLUSIONS:The overall surgical successful rate for consecutive exotropia in this study was 62.96%. Combined MR advancement and LR recession yielded better results than MR advancement or LR recession alone although it was not statistically significant.