Unilateral versus bilateral lateral rectus recession for correction of small to moderate angle exotropia.
Bilateral lateral rectus recession
Lateral incomitance
Limited ductions
Moderate-angle exotropia
Small-angle exotropia
Unilateral lateral rectus recession
Journal
International ophthalmology
ISSN: 1573-2630
Titre abrégé: Int Ophthalmol
Pays: Netherlands
ID NLM: 7904294
Informations de publication
Date de publication:
17 Oct 2024
17 Oct 2024
Historique:
received:
18
06
2024
accepted:
28
09
2024
medline:
18
10
2024
pubmed:
18
10
2024
entrez:
17
10
2024
Statut:
epublish
Résumé
To compare the effect of unilateral versus bilateral lateral rectus (LR) recession for correction of small to moderate exotropia. Records of all patients with exotropia 14-35 prism diopters (∆), operated upon by the authors, were included in a retrospective study to compare the effect of unilateral (Group 1) versus bilateral (Group 2) LR recession. The study end-point was the last follow-up visit scheduled at least 3 months postoperatively. A successful outcome was defined as 0-10∆ of horizontal tropia. The study included 154 patients (47 in Group 1 and 107 in Group 2). Patients were followed up for 3-120 months (26.7 ± 24.88). A successful outcome was achieved in 83% in Group 1 and 82.2% in Group 2 (p = .976), with higher success in group 1 for surgical target angles up to 25∆. All failures in Group 1 were due to undercorrections., while the 17.8% failure rate in Group 2 comprised 15% undercorrections and 2.8% overcorrections (p = .419). Persistent lateral incomitance was seen in 29.5% in Group 1 versus 2.3% in Groups 2 (p < .001). Lateral incomitance was encountered in 71% of those undergoing 10 mm unilateral recessions, versus 20% of those who had smaller recession doses. Limited ductions were mild, and exceeded -1 in only 4 cases: 3 had had 10 mm and 1 had had 9 mm unilateral LR recession. Unilateral and bilateral LR recessions offer essentially equal success rates. Unilateral recessions are advised for angles up to 25∆, without exceeding 10 mm.
Identifiants
pubmed: 39419908
doi: 10.1007/s10792-024-03324-1
pii: 10.1007/s10792-024-03324-1
doi:
Types de publication
Journal Article
Comparative Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
408Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer Nature B.V.
Références
Wang L, Nelson LB (2010) One-muscle strabismus surgery. Curr Opin Ophthalmol 21(5):335–340
doi: 10.1097/ICU.0b013e32833bd953
pubmed: 20531188
Gurland J, Vagge A, Nelson LB (2018) One-muscle strabismus surgery: a review. J Pediatr Ophthalmol Strabismus 55(5):288–292
doi: 10.3928/01913913-20180327-03
pubmed: 29913025
Kimberly MS, Areaux RG (2022) Unilateral horizontal rectus muscle recessions for pediatric comitant strabismus. J Binocul Vis Ocul Motil 72(3):147–150
doi: 10.1080/2576117X.2022.2073167
Wright KW, Strube YNJ (2015) Appendix A: surgical numbers. In: Wright KW, Strube YNJ (eds) Color atlas of strabismus surgery: strategies and techniques, 4th edn. Springer, New York, pp 191–192
doi: 10.1007/978-1-4939-1480-7
Lekskul A, Wuthisiri W, Jarupanich N (2021) A prospective study of one-muscle surgery in 15–25 prism diopters horizontal comitant strabismus in adults. Clin Ophthalmol 15:3669–3678
doi: 10.2147/OPTH.S324517
pubmed: 34511870
pmcid: 8418371
Deutsch JA, Nelson LB, Sheppard RW, Burke MJ (1992) Unilateral lateral rectus recession for the treatment of exotropia. Ann Ophthalmol 24(3):111–113
pubmed: 1570925
Kamlesh DS (2003) Long-term results of unilateral lateral rectus recession in intermittent exotropia. J Pediatr Ophthalmol Strabismus 40(5):283–287
doi: 10.3928/0191-3913-20030901-09
pubmed: 14560836
Zak TA (1986) Results of large single medial rectus recession. J Pediatr Ophthalmol Strabismus 23(1):17–21
doi: 10.3928/0191-3913-19860101-05
pubmed: 3950837
Nelson LB, Bacal DA, Burke MJ (1992) An alternative approach to the surgical management of exotropia–the unilateral lateral rectus recession. J Pediatr Ophthalmol Strabismus 29(6):357–360
doi: 10.3928/0191-3913-19921101-06
pubmed: 1287172
Olitsky SE (1998) Early and late postoperative alignment following unilateral lateral rectus recession for intermittent exotropia. J Pediatr Ophthalmol Strabismus 35(3):146–148
doi: 10.3928/0191-3913-19980501-05
pubmed: 9627874
Procianoy E, Justo DM (1991) Results of unilateral medial rectus recession in high AC/A ratio esotropia. J Pediatr Ophthalmol Strabismus 28(4):212–214
doi: 10.3928/0191-3913-19910701-06
pubmed: 1919968
Weakley DR Jr, Stager DR (1993) Unilateral lateral rectus recessions in exotropia. Ophthalmic Surg 24(7):458–460
pubmed: 8351092
Menon V, Singla MA, Saxena R, Phulijele S (2010) Comparative study of unilateral and bilateral surgery in moderate exotropia. J Pediatr Ophthalmol Strabismus 47(5):288–291
doi: 10.3928/01913913-20091118-07
pubmed: 19928700
Hopker LM, Weakley DR (2013) Surgical results after one-muscle recession for correction of horizontal sensory strabismus in children. J AAPOS 17(2):174–176
doi: 10.1016/j.jaapos.2012.10.024
pubmed: 23622449
Pollard ZF, Manley D (1976) Unilateral medial rectus recession for small-angle esotropia. Arch Ophthalmol 94(5):780–781
doi: 10.1001/archopht.1976.03910030384006
pubmed: 1267654
Spierer O, Spierer A (2021) Unilateral lateral rectus recession is an effective surgery for intermittent exotropia in young children. BMC Ophthalmol 21(1):10
doi: 10.1186/s12886-020-01778-2
pubmed: 33407259
pmcid: 7788696
Lyu IJ, Park KA, Oh SY (2016) Long-term surgical outcomes and factors for recurrence after unilateral lateral rectus muscle recession. Br J Ophthalmol 100(10):1433–1436
doi: 10.1136/bjophthalmol-2015-307970
pubmed: 26769671
Spierer A, Ben-Simon GJ (2005) Unilateral and bilateral lateral rectus recession in exotropia. Ophthalmic Surg Lasers Imaging 36(2):114–117
doi: 10.3928/1542-8877-20050301-06
pubmed: 15792311
Wang L, Nelson LB (2010) Outcome study of unilateral lateral rectus recession for small to moderate angle intermittent exotropia in children. J Pediatr Ophthalmol Strabismus 47(4):242–247
doi: 10.3928/01913913-20091019-12
pubmed: 19873943
Almahmoudi FH, Al Shamrani M, Khan AM (2018) The use of one muscle recession for horizontal strabismus. Saudi J Ophthalmol 32(3):200–203
doi: 10.1016/j.sjopt.2018.05.001
pubmed: 30224883
pmcid: 6137830
Cogen MS, Roberts BW (2006) Graded unilateral supramaximal medial rectus recession for moderate angle esotropia. Binocul Vis Strabismus Q 21(3):147–153
pubmed: 16934026
Wang L, Wang X (2012) Comparison between graded unilateral and bilateral medial rectus recession for esotropia. Br J Ophthalmol 96(4):540–543
doi: 10.1136/bjophthalmol-2011-300932
pubmed: 22096137
Grin TR, Nelson LB (1987) Large unilateral medial rectus recession for the treatment of esotropia. Br J Ophthalmol 71(5):377–379
doi: 10.1136/bjo.71.5.377
pubmed: 3580356
pmcid: 1041171
Stack RR, Burley CD, Bedggood A, Elder MJ (2003) Unilateral versus bilateral medial rectus recession. J AAPOS 7(4):263–267
doi: 10.1016/S1091-8531(03)00117-4
pubmed: 12917613
Wang L, Nelson LB (2011) Outcome study of graded unilateral medial rectus recession for small to moderate angle esotropia. J Pediatr Ophthalmol Strabismus 48(1):20–24
doi: 10.3928/01913913-20100818-05
pubmed: 20795601
Oh SY, Choi HY, Lee JY, Oh SY (2020) Surgical outcomes related to degree of unilateral lateral rectus muscle recession in intermittent exotropia of 20 prism diopters. Jpn J Ophthalmol 64(6):621–627
doi: 10.1007/s10384-020-00771-y
pubmed: 32951138
Spierer O, Spierer A, Glovinsky J, Ben-Simon GJ (2010) Moderate- angle exotropia: a comparison of unilateral and bilateral rectus muscle recession. Ophthalmic Surg Lasers Imaging 41(3):355–359
doi: 10.3928/15428877-20100430-10
pubmed: 20507021
Kim HJ, Kim D, Choi DG (2014) Long-term outcomes of unilateral lateral rectus recession versus recess-resect for intermittent exotropia of 20–25 prism diopters. BMC Ophthalmol 14:46
doi: 10.1186/1471-2415-14-46
pubmed: 24708678
pmcid: 3983853
Suh SY, Choi J, Kim SJ (2015) Comparative study of lateral rectus recession versus recession-resection in unilateral surgery for intermittent exotropia. J AAPOS 19(6):507–511
doi: 10.1016/j.jaapos.2015.08.011
pubmed: 26691028
Yang HK, Kim MJ, Hwang JM (2015) Predictive factors affecting long-term outcome of unilateral lateral rectus recession. PLoS ONE 10(9):e0137687
doi: 10.1371/journal.pone.0137687
pubmed: 26418819
pmcid: 4587954
Kim H, Yang HK, Hwang JM (2016) Comparison of long-term surgical outcomes between unilateral recession and unilateral recession-resection in small-angle exotropia. Am J Ophthalmol 166:141–148
doi: 10.1016/j.ajo.2016.03.047
pubmed: 27066724
Feretis D, Mela E, Vasilopoulos G (1990) Excessive single lateral rectus muscle recession in the treatment of intermittent exotropia. J Pediatr Ophthalmol Strabismus 27:315–316
doi: 10.3928/0191-3913-19901101-10
pubmed: 2086749