Results of Unilateral Lateral Rectus Recession Surgery in 15 – 30 PD Intermittent Exotropia

Abstract

Purpose To evaluate the surgical outcomes of unilateral lateral rectus muscle recession (ULR) with low surgical dosage in patients with intermittent exotropia (IXT) of 15 – 30 prism dioptres (PD).

Methods We retrospectively analysed 92 eyes of 92 patients who underwent ULR surgery with the diagnosis of IXT of 15 – 30 PD at distance fixation between January 2017 and June 2019. ULR surgery of 6.5 mm was performed for exotropia of 15 – 20 PD, 7.5 mm for that of 20 – 25 PD, and 8.5 mm for that of 25 – 30 PD and postoperative results were evaluated at the 1st week, 1st month, 6th month, and the 2nd year. Orthophoria or IXT less than 10 PD was accepted as successful.

Results The mean preoperative deviation angle at distance was 22.3 ± 4.4 PD. Mean postoperative deviation angles at distance were 2.5 ± 1.7, 3.9 ± 2.4, 6.5 ± 3.0, and 8.7 ± 3.1 at 1 week, 1 month, 6 months, and 2 years, respectively. The surgical success rate of ULR was 100, 96.7, 84.7, and 77.1% at the 1st week, 1st month, 6th month, and the 2nd year, respectively. In the long-term results, there were no complications such as lateral gaze incomitance, overcorrection, or deterioration in stereopsis.

Conclusion Using the ULR technique, we were able to obtain effective surgical results in IXT with less surgical dosage and without any serious complications. ULR surgery can be used as an effective method in patients with IXT of 15 – 30 PD.

Zusammenfassung

Ziel Bewertung der chirurgischen Ergebnisse einer einseitigen Rücklagerung des lateralen Rektusmuskels (ULR) mit niedriger chirurgischer Dosierung bei Patienten mit intermittierender Exotropie (IXT) von 15 – 30 Prismendioptrien (PD).

Methoden Wir analysierten retrospektiv 92 Augen von 92 Patienten, die sich zwischen Januar 2017 und Juni 2019 einer ULR-Operation mit der Diagnose einer IXT von 15 – 30 PD bei Fernfixation unterzogen hatten. Bei einer Exotropie von 15 – 20 PD wurde eine ULR-Operation von 6,5 mm durchgeführt, bei 20 – 25 PD eine ULR-Operation von 7,5 mm und bei 25 – 30 PD von 8,5 mm. Postoperative Ergebnisse wurden in der 1. Woche, im 1. Monat, 6. Monat und 2. Jahr ausgewertet. Orthophorie oder intermittierende Exotropie von weniger als 10 PD wurde als erfolgreich akzeptiert.

Ergebnisse Der mittlere präoperative Schielwinkel in der Ferne betrug 22,3 ± 4,4 PD. Der mittlere postoperative Schielwinkel in der Ferne betrug 2,5 ± 1,7, 3,9 ± 2,4, 6,5 ± 3,0 und 8,7 ± 3,1 in der 1. Woche, im 1. Monat, 6. Monat bzw. 2. Jahr. Die chirurgische Erfolgsrate der ULR betrug 100%, 96,7%, 84,7% und 77,1% in der 1. Woche, im 1. Monat, 6. Monat bzw. 2. Jahr. In den Langzeitergebnissen zeigten sich keine Komplikationen wie seitliche Blickinkomitation, Überkorrektur und Verschlechterung der Stereopsis.

Schlussfolgerungen Dank unserer Operationstechnik konnten wir effektive chirurgische Ergebnisse in IXT mit geringerer chirurgischer Dosis ohne schwerwiegende Komplikationen erzielen. Die ULR-Operation kann als effektive Methode bei Patienten mit IXT von 15 – 30 PD eingesetzt werden.

Already known

• Different results were reported regarding the success rate of unilateral lateral rectus muscle recession (ULR) surgery for intermittent exotropia (IXT).

• Likewise, different surgical doses have been suggested for successful outcomes.

• In this study, we retrospectively examined the surgical outcomes of ULR surgery with a different surgical technique in patients who had lower surgical doses than the conventional dosage.

Newly described

• ULR surgery has many advantages and satisfactory results in patients with IXT.

• Furthermore, thanks to our surgical technique, we were able to achieve satisfactory results with a lower surgical dosage.

Key words

intermittent exotropia - unilateral lateral rectus recession - recurrence - low surgical dose

Schlüsselwörter

intermittierende Exotropie - Rezidiv - einseitige laterale Rücklagerung

Publication History

Received: 20 June 2022

Accepted: 29 December 2022

Article published online:
04 April 2023

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