Comparison of Unilateral Versus Bilateral Lateral Rectus Recession for Small Angle Intermittent Exotropia: Outcomes and Surgical Dose-Responses
| Autor: | Ming-Han Hugo, Lee, David R, Smith, Stephen P, Kraft, Michael J, Wan |
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| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | Journal of Pediatric Ophthalmology & Strabismus. 59:350-355 |
| ISSN: | 1938-2405 0191-3913 |
| DOI: | 10.3928/01913913-20220131-03 |
| Popis: | Purpose: To compare the surgical outcomes of unilateral lateral rectus recession to bilateral lateral rectus recession for small angle intermittent exotropia. Methods: This was a retrospective cohort study of pediatric patients with an intermittent exotropia between 16 and 20 prism diopters (PD) who underwent unilateral lateral rectus recession or bilateral lateral rectus recession at a single tertiary care pediatric hospital. The primary outcome was success (exotropia < 10 PD of esotropia < 5 PD, no decrease in stereopsis > 0.6 log arcsec, and no reoperation) at 12 months postoperatively. Secondary outcomes included survival analysis of time to surgical failure, surgical dose-response, and improvement in central fusion or stereopsis. Results: At 12 months, successful outcomes were achieved in 13 of 27 patients (46%) in the bilateral lateral rectus recession group and 19 of 28 patients (70%) in the unilateral lateral rectus recession group, which was not a statistically significant difference ( P = .10). Survival analysis showed a trend toward a higher rate of failure in the bilateral lateral rectus recession group compared to the unilateral lateral rectus recession group ( P = .04). The mean surgical dose-response was 1.7 PD/mm at 1 week and 1.0 PD/mm at 12 months for the bilateral lateral rectus recession group, and 2.0 PD/mm at 1 week postoperatively and 1.4 PD/mm at 12 months postoperatively for the unilateral lateral rectus recession group. There were no cases of long-term postoperative lateral incomitance in either group. Conclusions: Unilateral lateral rectus recession and bilateral lateral rectus recession have similar success rates for small angle intermittent exotropia after at least 12 months of follow-up. Randomized controlled trials in surgical management of intermittent exotropia should consider unilateral lateral rectus recession as a treatment arm. [ J Pediatr Ophthalmol Strabismus . 2022;59(5):350–355.] |
| Databáze: | OpenAIRE |
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