Comparison of Postoperative Exodrift after First Unilateral and Second Contralateral Lateral Rectus Recession in Recurrent Exotropia
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Purpose: To compare postoperative exodrift of the first unilateral lateral rectus (ULR) muscle recession with theexodrift of the second contralateral ULR muscle recession in patients with recurrent small-angle exotropia (XT). Methods: We evaluated the results of a second ULR muscle recession in 19 patients with recurrent XT with deviationangles under 25 prism diopter (PD), following a first procedure of ULR muscle recession for small-angleXT. Recession of the lateral rectus muscle ranged from 8 to 9 mm. The postoperative motor alignment anddegree of exodrift were investigated after the first ULR muscle recession and the second ULR muscle recessionin the same patients. Results: Observed differences in postoperative ocular alignment between the first ULR muscle recession andthe second ULR muscle recession were statistically significant at follow-up periods of six months (7.84 ± 4.43vs. 3.89 ± 3.47 PD), one year (9.58 ± 4.97 vs. 5.21 ± 4.94 PD), and at a final follow-up (21.11 ± 2.98 vs. 7.52 ± 4.06PD) after surgery (p = 0.006, 0.013, and 0.000). Postoperative exodrift was statistically different between thefirst and second ULR muscle recessions at three to six months (2.89 ±3.75 vs. 0.63 ± 3.45 PD) and one yearto final follow-up (11.52 ± 5.50 vs. 2.32 ± 3.53 PD) (p = 0.034 and 0.000). All of the first ULR muscle recessionpatients showed XT with deviation angles of more than 15 PD at the final follow-up. Regardless, the surgicalsuccess rate (<8 PD) after the second ULR recession was 63.16% (12 patients) among the total amount ofpatients with recurrent XT. Conclusions: This study shows that changes in exodrift after a second ULR muscle recession are less thanchanges after the first URL muscle recession among patients with recurrent XT. A second ULR muscle recessionmay be a useful surgery for small-angle XT patients with deviation angles of 25 PD or less after a firstULR muscle recession.
Abstract
Purpose: To compare postoperative exodrift of the first unilateral lateral rectus (ULR) muscle recession with theexodrift of the second contralateral ULR muscle recession in patients with recurrent small-angle exotropia (XT). Methods: We evaluated the results of a second ULR muscle recession in 19 patients with recurrent XT with deviationangles under 25 prism diopter (PD), following a first procedure of ULR muscle recession for small-angleXT. Recession of the lateral rectus muscle ranged from 8 to 9 mm. The postoperative motor alignment anddegree of exodrift were investigated after the first ULR muscle recession and the second ULR muscle recessionin the same patients. Results: Observed differences in postoperative ocular alignment between the first ULR muscle recession andthe second ULR muscle recession were statistically significant at follow-up periods of six months (7.84 ± 4.43vs. 3.89 ± 3.47 PD), one year (9.58 ± 4.97 vs. 5.21 ± 4.94 PD), and at a final follow-up (21.11 ± 2.98 vs. 7.52 ± 4.06PD) after surgery (p = 0.006, 0.013, and 0.000). Postoperative exodrift was statistically different between thefirst and second ULR muscle recessions at three to six months (2.89 ±3.75 vs. 0.63 ± 3.45 PD) and one yearto final follow-up (11.52 ± 5.50 vs. 2.32 ± 3.53 PD) (p = 0.034 and 0.000). All of the first ULR muscle recessionpatients showed XT with deviation angles of more than 15 PD at the final follow-up. Regardless, the surgicalsuccess rate (<8 PD) after the second ULR recession was 63.16% (12 patients) among the total amount ofpatients with recurrent XT. Conclusions: This study shows that changes in exodrift after a second ULR muscle recession are less thanchanges after the first URL muscle recession among patients with recurrent XT. A second ULR muscle recessionmay be a useful surgery for small-angle XT patients with deviation angles of 25 PD or less after a firstULR muscle recession.
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