Rectus Recession For Exotropia Research Articles

Correlation between the axial length and the effect of recession of horizontal rectus muscles

Purpose The aim of this study is to determine whether the axial length (AxL) measurement would be useful in predicting the effect of horizontal rectus muscles recession. Patients and methods This study retrospectively reviewed 94 patients (52 with intermittent exotropia and 42 with infantile esotropia and partially accommodative esotropia), with age ranging from 4 to 15 years (7.63±3.2). All cases underwent bilateral lateral rectus recession for exotropia and bilateral medial recession for esotropia; there were no cases of combined vertical strabismus. There was no history of any ocular trauma or previous strabismus surgery. Preoperative angle of deviation, AxL (IOL Master), and postoperative angle of deviation at 6 months were recorded; effect of recession was calculated in all cases. Results The mean AxL for all cases was 23.39±1.73. The patients were divided into two groups: exotropia group (n=52) and esotropia group (n=42). Each group was subdivided into two subgroups: subgroup I (AxL<23.39) and subgroup II (AxL≥23.39). The effect of recession in exotropic group was 2.27±0.29; in short AxL subgroup, it was 2.42±0.17, and in long AxL subgroup, it was 1.98±0.25. In esotropic group, the effect of recession was 3.36±0.53; in subgroup I, it was 3.67±0.31, and in subgroup II, it was 2.87±0.44. Conclusion The results showed a negative correlation between AxL and effect of recession in both esotropia and exotropia groups. It is recommended to increase the amount of recession in longer AxL.

Surgical responses and outcomes of bilateral lateral rectus recession in exotropia with cerebral palsy.

To determine surgical responses and outcomes of bilateral lateral rectus (BLR) recession in exotropes with cerebral palsy (CP) and to compare the results with exotropes without CP. Forty-one exotropes with CP and 82 age- and type (intermittent or constant)-matched exotropes without CP who underwent BLR recession by one surgeon (J-M.H.) were evaluated. Main outcome measures were surgical responses, factors affecting surgical response, success rates, cumulative probabilities of success and recurrence, and drifts of ocular alignment towards exodeviation after surgery (exodrift). The surgical responses of BLR recession were not significantly different between both groups (p=0.136). After a mean follow-up period of 2years, success rates showed no significant difference between the two groups (p=1.000). The cumulative probabilities of success and recurrence were not significantly different between the two groups (p=0.770 and 0.754, respectively). The rate of recurrence per person-year during follow-up was 16.7% in patients with CP and 20.2% in patients without CP. The amount of exodrift showed no significant difference between both groups (p=0.118). Exotropes with CP showed a similar surgical response, an amount of exodrift, cumulative success and recurrence rates after BLR recession compared to exotropes without CP.

The Effect of Bilateral Slanted Lateral Rectus Recession in Exotropia with Near-Far Disparity

The Effect of Bilateral Slanted Lateral Rectus Recession in Exotropia with Near-Far Disparity

Contemplation of the Surgical Normogram of Lateral Rectus Recession for Exotropia Associated with Superior Oblique Palsy

PurposeTo suggest a surgical normogram for lateral rectus recession in exotropia associated with unilateral or bilateral superior oblique muscle palsy (SOP).MethodsWe retrospectively reviewed the charts of 71 patients with exotropia who were successfully corrected over one year. Each patient had undergone unilateral or bilateral rectus recession associated with uni- or bilateral inferior oblique (IO) 14 mm recession, using a modified surgical normogram for lateral rectus (LR) recession, which resulted in 1 to 2 mm of reduction of LR recession. We divided all patients into 2 groups, the 34 patients who had undergone LR recession with unilateral IO (UIO) recession group and the remaining 37 patients who had undergone LR recession with bilateral IO (BIO) recession group. Lateral incomitancy was defined when the exoangle was reduced by more than 20% compared to the primary gaze angle. The surgical effects (prism diopters [PD]/mm) of LR recession were compared between the two groups using the previous surgical normogram as a reference (Parks' normogram).ResultsThe mean preoperative exodeviation was 20.4 PD in the UIO group and 26.4 PD in the BIO group. The recession amount of the lateral rectus muscle ranged from 4 to 8.5 mm in the UIO group and 5 to 9 mm in the BIO group. Lateral incomitancy was noted as 36.4% and 70.3% in both groups, respectively (p = 0.02). The effect of LR recession was 3.23 ± 0.84 PD/mm in the UIO group and 2.98 ± 0.62 PD/mm in the BIO group and there was no statistically significant difference between two the groups (p = 0.15).ConclusionsReduction of the LR recession by about 1 to 2 mm was successful and safe to prevent overcorrection when using on IO weakening procedure, irrespective of the laterality of SOP.

Unilateral and Bilateral Lateral Rectus Recession in Exotropia

To evaluate the surgical results obtained by unilateral and bilateral lateral rectus recession for the correction of exotropia. The charts of all patients with exotropia who were operated on at the Goldschleger Eye Institute at Sheba Medical Center during an 11-year period were retrospectively reviewed. Study participants all underwent a complete orthoptic and ocular examination. Twenty-five patients with moderate-angle exotropia underwent unilateral lateral rectus recession (group 1) and 38 patients with large-angle exotropia underwent bilateral lateral rectus recession (group 2). The angle of exotropia was measured by the prism and cover test. Moderate exotropia was defined as 25 prism diopters (PD) and large-angle exotropia as greater than 25 PD. The mean age at the time of the surgery was 10.0+/-5.2 years in group 1 and 8.5+/-8.0 years in group 2. The mean preoperative exotropia was 16.1+/-5.7 PD in group 1 and 29.6+/-14.4 PD in group 2. A mean postoperative exodeviation of 4.2+/-5.4 PD was found in group 1 and 5.8+/-13.6 PD in group 2. The success rate (deviation of < 10 PD) was 84% in group 1 and 74% in group 2. There was no incomitance in group 1. Unilateral lateral rectus recession is an effective surgical method for correcting moderate-angle exotropia with results similar to bilateral lateral rectus recession for larger exotropia angles.