Outcome of monocular surgery for horizontal strabismus in Hyderabad

Junejo, Sameen Afzal; Ansari, Munawar Alam

doi:10.2147/opth.s8892

Cited by 3 publications

(4 citation statements)

References 20 publications

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“…Many define satisfactory alignment as within 10 PD of orthotropia, [13,23,27] while others extend the criteria to within 15 PD [28,29]. …”

Section: Discussionmentioning

confidence: 99%

“…The pre-operative deviations of 60 PD or less illustrated success with the unilateral recess/resect procedure, but they stated difficulty in visually aligning the eyes by operating only on one eye because of larger deviations of more than 60 PD. Thus according to them at this stage, clinical circumstances for a second surgery on the fixing eye or binocular squint surgery concerning more than two horizontal rectus muscles is the main and extensive used clinical procedure [29]. Jeoung et.al, in his comparative study found the significantly higher surgical success in patients with the unilateral recess/resect procedure than those having bilateral lateral rectus recession.…”

Section: Discussionmentioning

confidence: 99%

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Outcome of unilateral lateral rectus recession and medial rectus resection in primary exotropia

et al. 2013

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BackgroundThe purpose of this study was to measure the success rate of unilateral lateral rectus recession and medial rectus resection in primary exotropia.MethodsThis is an interventional case series of 55 patients with primary exotropia (degree of deviation 15–85 PD), above the age of 5 years. Patients were treated in the Department of Ophthalmology, Jinnah Postgraduate Medical Center, Karachi, Pakistan, during the period of July 2009 to March 2010. All the patients underwent surgical procedure i.e., lateral rectus muscle recession (maximum up to 10 mm) and medial rectus muscle resection (up to 6 mm) of one eye, according to the Park’s method. Surgery was done based on prism cover test measurements obtained at 6 m with appropriate optical correction in place. Patients were re evaluated at one day, one month, two months and six months post operatively. Final outcome was considered at the end of six months at which achievement of ≤10 PD of exotropia was the success. Data was analyzed on SPSS version 17.0.ResultsWe obtained success (≤10 PD) in 42 out of 55 patients (76.4%) and 13 out of 55 patients (23.6%) did not meet our criteria for surgical success (>10 PD). Analysis of success with the type of primary exotropia showed that success was achieved in 22 out of 24 cases of intermittent type (91.6%) and 20 out of 31 cases of constant type (64.5%)(P Value 0.019). The highest percentage of success was achieved in patients with the pre-operative deviation of ≤70 PD i.e., 93.3% (42 out of 45 cases), while none of the patients with the pre-operative deviation of >70 PD (10 out of 10 cases) achieved the criteria for success.ConclusionWe conclude that pre-operative deviation is one of the strongest predictor for favorable surgical outcome. Therefore, eliminating the factors causing error in the correct determination of pre-operative deviation should improve the success and predictability of the surgical outcome. Despite the obstacles in the surgical management of strabismus, our results are encouraging.

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“…Many define satisfactory alignment as within 10 PD of orthotropia, [13,23,27] while others extend the criteria to within 15 PD [28,29]. …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Outcome of unilateral lateral rectus recession and medial rectus resection in primary exotropia

et al. 2013

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“…For these cases, a second surgery was required with more than two muscle procedure. 19 In our study, one patient with exotropia > 60 PD required second surgery.…”

Section: Discussionmentioning

confidence: 59%

“…The favourable age for operation is when the child can be assessed for orthoptic correction and also when the functional and cosmetic symptoms become too apparent. [15][16][17][18] According to the study conducted by Junejo SA et al, 19 the desired postop effect was seen with preoperative deviation of < 60 PD. With deviation > 60 PD, there was difficulty in aligning the eyes with operation only on one eye.…”

Section: Discussionmentioning

confidence: 99%

Surgical Outcome of Unilateral Lateral Rectus Recession and Medial Rectus Resection in Large-Angle Exotropia

Kumar¹,

Ralte²

2017

jemds

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BACKGROUNDExotropia is a manifest outward deviation of the visual axes, which is either constantly or intermittently present. Untreated poorly controlled intermittent exotropia later progresses to constant exotropia. Sensory exotropia is unilateral divergent misalignment of the eyes, resulting from loss of vision or long-standing poor vision in an eye.The objective of this study is to evaluate the result of unilateral lateral rectus recession and medial rectus resection in largeangle exotropia more than 60 PD and to assess intraoperative and postoperative complications.Settings-Tertiary Eye Care Centre, Ranchi, India. MATERIALS AND METHODSConsecutive patients with large-angle exotropia more than 60 PD who underwent unilateral lateral rectus recession and medial rectus resection between January 2015 and December 2016 were retrospectively studied. Postoperative residual deviations and any intraoperative and postoperative complications were assessed. RESULTSThe case series included sixteen patients (11 males and 5 females). Mean age of the patients were 21.25 ± 4.31 years. The mean preoperative deviations at distance and near were 67 ± 12 PD and 69 ± 14 PD respectively. The postoperative result showed that 11 patients had orthotropia (68.8%), 3 patients (18.7%) had undercorrection of 10 PD and two patients (12.5%) had undercorrection of 15 -20 PD. Only one patient with undercorrection of 20 PD required second surgery. None of the patients had any intraoperative complications related to surgery or anaesthesia. CONCLUSIONUnilateral single stage two-muscle surgery gives good result and can be done as first procedure for large-angle exotropia of > 60 PD.

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Gender differences in horizontal strabismus: Systematic review and meta-analysis shows no difference in prevalence, but gender bias towards females in the clinic

Laughton,

Hagen,

Yang

et al. 2023

J Glob Health

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Background Strabismus is a misalignment of the visual axis that affects 2-3% of the population and can lead to loss of binocular vision. It is currently controversial whether there is a gender difference in the most common form of visual misalignment: horizontal strabismus. Some studies claimed that more females than males have an outward deviation (exotropia), while others concluded that there is no significant gender difference. No previous work has systematically explored gender differences in horizontal strabismus or has compared the results of population-based studies with those of clinic-based studies. Methods We conducted a systematic review and meta-analysis of studies reporting the prevalence of horizontal strabismus. We included 73 population-based studies and compared their disclosed gender population with that in 141 comparable clinical-based studies. We analysed the data according to gender, strabismus type (esotropia, exotropia), and geographic region/ethnicity. Results Summary statistics showed a nearly identical prevalence of horizontal strabismus (2.558% for males, 2.582% for females), esotropia (1.386% males vs. 1.377% females), and of exotropia (1.035% males vs. 1.043% females). Meta-analysis results showed that these differences between males and females were not statistically significant (odds ratio (OR) = 1.01; 95% confidence interval (CI) = 0.97-1.10), but that females were significantly more frequent (by 7.50%) in clinic-based studies than males, with 5.00% more females for esotropia, and 12.20% more females for exotropia when adjusted for the population’s sex ratio. The extent of the female gender bias differed between geographic regions/societies, with Asians having the lowest bias towards females and Latin American countries having the strongest bias. Conclusions Males and females have the same prevalence of horizontal strabismus, including exotropia. Females with strabismus seek health care or are brought to clinics significantly more often than males. This is an example of gender bias in health care in favour of females rather than males, apparently because parents – erroneously fearing only cosmetic consequences – are more concerned about strabismus in their daughters than their sons. Societal attitudes towards females, as well as economic factors (insurance status), appear to be relevant factors that determine the magnitude of the gender bias in horizontal strabismus.

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Outcome of monocular surgery for horizontal strabismus in Hyderabad

Cited by 3 publications

References 20 publications

Outcome of unilateral lateral rectus recession and medial rectus resection in primary exotropia

Outcome of unilateral lateral rectus recession and medial rectus resection in primary exotropia

Surgical Outcome of Unilateral Lateral Rectus Recession and Medial Rectus Resection in Large-Angle Exotropia

Gender differences in horizontal strabismus: Systematic review and meta-analysis shows no difference in prevalence, but gender bias towards females in the clinic

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