Short-term Surgical Outcomes of Rectus Muscle Plication and Resection in Intermittent Exotropia
- Authors
- Lee, Jung Woo; Kim, Hoon Dong; Kim, So Young
- Issue Date
- Feb-2019
- Publisher
- 대한안과학회
- Keywords
- Exotropia; Surgical outcomes; Plication; Resection
- Citation
- 대한안과학회지, v.60, no.2, pp 169 - 175
- Pages
- 7
- Journal Title
- 대한안과학회지
- Volume
- 60
- Number
- 2
- Start Page
- 169
- End Page
- 175
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/4734
- DOI
- 10.3341/jkos.2019.60.2.169
- ISSN
- 0378-6471
2092-9374
- Abstract
- Purpose: To evaluate the efficacy and safety of medial rectus muscle plication compared to resection, coupled with antagonist muscle recession, as treatments for intermittent exotropia (IXT). Methods: We retrospectively reviewed the charts of IXT patients treated by a single surgeon and followed-up for at least 6 months between September 2016 and February 2017. The patients were divided into three groups: a bilateral lateral rectus muscle recession (BLR) group, a unilateral lateral rectus recession with medial rectus plication (R&P) group, and a unilateral lateral rectus recession with medial rectus resection (R&R) group. Serial changes in ocular alignment at 4-24 weeks after surgery were compared among the groups. In addition, the operative times were assessed. Results: We included 119 patients (mean age 6.65 +/- 2.79 years). The preoperative exodeviation was 29.81 +/- 7.31 prism diopters (PDs) and did not differ among the groups. The R&P group exhibited significantly less postoperative deviation than the BLR group. The operative time was significantly less for the R&P group (25.77 +/- 9.29 minutes) than the R&R group (28.97 +/- 5.74 minutes). The success rates were identical among groups at 6 months; no severe adverse events were recorded apart from one case of dellen that improved after application of a topical agent. Conclusions: Plication may reduce the risk for anterior segment ischemia to a level lower than the risks associated with other procedures, and also facilitate reoperation if necessary. We found that R&P took less time but had success rate similar to BLR and R&R. Thus, medial rectus muscle plication for IXT patients is a valuable alternative procedure when the external rectus muscle requires strengthening.
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