| [Background] Exotrpia with surgery and exotrpia without surgery are two ways of the treatment for exotropia.Fusion training and negative spherical are included in non-surgical ways.If there exist deviations which is more than12PD,the patients should be operated.The surgery not only correct the deviation but also improve binocular function. The common surgeries for exotropia are bilateral lateral rectus recession,unilateral lateral rectus recession combined with medial rectus rescession and unilateral lateral rectus recession.The major treatment for exotropia has been surgical process at present. And it is less reported that the patients with exotropia underwent unilateral lateral rectus recession. Even more,there has been no articles are reported that compared the surgical effectiveness of the treatment of unilateral lateral rectus recession with intermittent exotropia and recurrent exotropia. According to international articles, this surgical process which is unilateral lateral rectus recession not only correct ocular alignment but also decrease the surgical injury, shorten the time of anesthesia and have better distance surgical effectiveness by the treatment of exotropia. It has been proved that there is no significance in the treatment of exotropia between unilateral lateral rectus recession and bilateral lateral rectus recession. Therefore, we evaluate the surgical success of the both groups,which underwent unilateral lateral rectus recession between the intermittent exotropia and recurrent exotropia, in order to guide the treatment of clinical.[Purpose] To compare the surgical outcomes of unilateral lateral rectus recession (ULR-rec) between the first surgery for treatment of intermittent exotropia and the second surgery for treatment of recurrent exotropia.[Methods] In this retrospective study, we reviewed the medical records of45patients who underwent ULR-rec for intermittent exotropia or recurrent intermittent exotropia (ULR-rec or R&R procedure performed in the first surgery) of12to25PD between October2011and November2012. Inclusion criteria were as follows:(1) no amblyopia (defined as a difference of at least2lines of Snellen visual acuity between two eyes);(2) no anisometropia as difference of greater than2.50diopters and no hyperopia or myopia greater than+6.00diopters spherical equivalent in either eye;(3) no A-or V-pattern and no simultaneous oblique surgery;(4)no ocular limit rotations owing to restrictive or paretic strabismus;(5) exodeviation at distance between12and25PD; and (6) postoperative follow-up for at least6months. Twenty-seven patients without a surgical history who underwent ULR-rec for basic and divergence excess type intermittent exotropia were classified as First-surgery group. Eighteen patients with a surgical history of ULR-rec or R&R for intermittent exotropia who underwent contralateral lateral rectus recession for recurrent exotropia were classified as Second-surgery group.Forty-five patients who underwent ULR-rec for12to25PD intermittent exotropia or recurrent intermittent exotropia with a minimum postoperative follow-up of6months were included in this retrospective study. Successful alignment was defined as±10PD of orthophoria in primary and lateral gaze.A x2test was applied to compare the success rates between the two groups. The t test was used to compare preoperative numerical data and postoperative deviated angle between the two groups. A p value of<0.05was considered statistically significant.[Results] At final follow-up of mean11±13months, surgical success rates were74.1%and77.8%in First-surgery group and Second-surgery group, respectively (p>0.05). There was no significant difference in the mean deviations between First-surgery group and Second-surgery group at all postoperative follow-up points (P>0.05).[Conclusions] Contralateral lateral rectus recession is an effective procedure for the treatment of recurrent exotropia of12to25PD after ULR-rec or R&R surgery for intermittent exotropia. |
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