Comparison of Long-term Surgical Outcomes of Two-muscle Surgery in Basic-type Intermittent Exotropia: Bilateral versus Unilateral
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Purpose: To compare long-term surgical outcomes after bilateral lateral rectus recession (BLR) and unilaterallateral rectus recession-medial rectus resection (RR) for the treatment of basic-type intermittent exotropia. Methods: Consecutive patients who underwent BLR or RR for treatment of intermittent exotropia between 1999and 2010 and underwent ≥5 years of follow-up were recruited for this study. Surgical outcomes were groupedaccording to postoperative angle of deviation: overcorrection (esophoria/tropia >8 prism diopters [Δ]), success(esophoria/tropia ≤8Δ to exophoria/tropia ≤8Δ), and undercorrection/recurrence (exophoria/tropia >8Δ). Outcomeswere compared between the BLR group and the RR group at postoperative week 1, months 1 and 6,and years 1, 2, 3, 4, and 5. Results: Of 99 patients, 37 underwent BLR and 62 underwent RR. At postoperative month 6 (97.3% vs. 82.3%,p = 0.045) and year 1 (91.9% vs. 74.2%, p = 0.040), the surgical success rates in the BLR group were significantlyhigher than in the RR group. Recurrence of exophoria/tropia most commonly occurred between 2 and3 years after surgery in the BLR group, but continuous recurrences were found in the RR group. At postoperativeyear 5, the surgical success rate was 54.1% in the BLR group and 41.9% in the RR group (p = 0.403). Thereoperation rate was 24.3% in the BLR group and 33.9% in the RR group (p = 0.317). Conclusions: Surgical outcomes 5 years after surgery for intermittent exotropia were comparable between theBLR and RR groups. The surgical success rate and the reoperation rate were not significantly different betweenthe BLR and RR groups.
Abstract
Purpose: To compare long-term surgical outcomes after bilateral lateral rectus recession (BLR) and unilaterallateral rectus recession-medial rectus resection (RR) for the treatment of basic-type intermittent exotropia. Methods: Consecutive patients who underwent BLR or RR for treatment of intermittent exotropia between 1999and 2010 and underwent ≥5 years of follow-up were recruited for this study. Surgical outcomes were groupedaccording to postoperative angle of deviation: overcorrection (esophoria/tropia >8 prism diopters [Δ]), success(esophoria/tropia ≤8Δ to exophoria/tropia ≤8Δ), and undercorrection/recurrence (exophoria/tropia >8Δ). Outcomeswere compared between the BLR group and the RR group at postoperative week 1, months 1 and 6,and years 1, 2, 3, 4, and 5. Results: Of 99 patients, 37 underwent BLR and 62 underwent RR. At postoperative month 6 (97.3% vs. 82.3%,p = 0.045) and year 1 (91.9% vs. 74.2%, p = 0.040), the surgical success rates in the BLR group were significantlyhigher than in the RR group. Recurrence of exophoria/tropia most commonly occurred between 2 and3 years after surgery in the BLR group, but continuous recurrences were found in the RR group. At postoperativeyear 5, the surgical success rate was 54.1% in the BLR group and 41.9% in the RR group (p = 0.403). Thereoperation rate was 24.3% in the BLR group and 33.9% in the RR group (p = 0.317). Conclusions: Surgical outcomes 5 years after surgery for intermittent exotropia were comparable between theBLR and RR groups. The surgical success rate and the reoperation rate were not significantly different betweenthe BLR and RR groups.
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