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

Saleem, Quratul Ain; Cheema, Alyscia; Tahir, Muhammad; Dahri, Arif Rabbani; Sabir, Tahir M; Niazi, Javed Hassan

doi:10.1186/1756-0500-6-257

Cited by 21 publications

(23 citation statements)

References 21 publications

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“…Several factors have been reported including age of surgery, preoperative deviation angle and high AC/A ratio [9] [10] [11]. Our study also showed significant positive correlation between mean dose response and preoperative angle of deviation.…”

Section: Discussionsupporting

confidence: 74%

Effect of Bilateral Lateral Rectus Recession in Intermittent Exotropia according to the Limbus Insertion Distance

Ghali¹

2017

OJOph

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Purpose: The aim of this work was the evaluation of the effect of the limbus insertion distance (LID) of the lateral rectus on the surgical results of bilateral lateral rectus recession in intermittent exotropia (IXT) in children and adults. Patients and Methods: This retrospective study included 76 patients. The patients were divided into two groups: group I (age 5 -13 y), group II (>13 y). All the patients had basic type of intermittent exotropia (IXT) and all of them underwent bilateral lateral recessions according to the preoperative angle of deviation. Intraoperatively, the distance of limbus insertion was measured by surgical calipers. The dose response effect was calculated as the difference between the preoperative angle and postoperative angle divided by total amount of recession and cases were followed at 1 month, 3 months, 6 months and 12 months postoperative. Results: The mean LID in group I was (6.2 ± 0.61 mm) and (6.1 ± 0.55 mm) in group II. The mean dose response (MDR) at 1 year postoperative was (2.32 ± 0.25 mm) in group I and (2.26 ± 0.23) in group II. In patients with LID < 5.5, the mean dose response was (1.98 ± 0.26) compared with that of patients with LID > 6.25 mm who had larger mean dose response (2.52 ± 0.15). There was a significant positive correlation between the LR muscle LID and the dose-response effect. Conclusion: There is positive correlation between the LID of the LR muscle and the recession effect in bilateral lateral rectus recession in treatment of IXT.

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Section: Discussionsupporting

confidence: 74%

Effect of Bilateral Lateral Rectus Recession in Intermittent Exotropia according to the Limbus Insertion Distance

Ghali¹

2017

OJOph

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“…The added benefit of this procedure is that if in case a second operation is needed some muscles have been preserved for it. 10 The postoperative result in our study showed that 68.8% patients had orthotropia, 18.7% patients had undercorrection of 10 PD and 12.5% patients had undercorrection of 15 -20 PD. Thus, 87.5% patients in our study had good cosmetically acceptable outcome.…”

Section: Discussionsupporting

confidence: 46%

“…But there is no definite cut-off to bring about a favourable outcome with two muscles procedure, because other factors play a role as well such as surgical technique and dose. 10 The mean age in our study is 21.25 ± 4.31 (12 -28 years). This higher age group could be due to patient's ignorance and late presentation to tertiary care centre.…”

Section: Discussionmentioning

confidence: 61%

“…For mediumangle exotropia two muscle surgery may be an option, while large-angle exotropia may need three or four muscle surgery. 10 According to Gezer and Kushner, they identified that the most important factor to determine the successful outcome of the surgery in exotropia is the preoperative deviation. 13,14 Thus, it has been accepted by many authors that preoperative deviation plays the most important role in determining the postoperative alignment.…”

Section: Discussionmentioning

confidence: 99%

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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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“…1,2,4,5 Seçilen cerrahi yöntem ve uygulama ile birlikte kaymanın başlangıç yaşı, cerrahi yaşı, refraksiyon kusuru, anizometropi ve duyusal durumu gibi hastanın klinik özelliklerine bağlı faktörlerin cerrahi başarıyı etkilediği bildirilmektedir. [6][7][8][9][10] Bu çalışmada, simetrik ve asimetrik cerrahi yapılan primer ekzotropya hastalarının motor ve duyusal sonuçlarının değerlendirilmesi amaçlanmıştır.…”

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Symmetric or Asymmetric Surgery in Cases with Primary Exotropia

Yurdakul¹

2019

Turkiye Klinikleri J Ophthalmol

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ir veya iki gözün dışa kayması olan ekzotropya primer, sekonder ve konsekütif olabilmektedir. 1 Devamlı veya aralıklı özellik gösteren primer ekzotropya sık görülen şaşılıklardan biridir. Genellikle forya şeklinde başladığı, zamanla devamlılık gösteren ekzotropyaya dönüştüğü ve hastaların %75'inin cerrahiye gittiği bildirilmektedir. 2,3 Turkiye Klinikleri J Ophthalmol. 2019;28(2):105-10 105 Primer Ekzotropya Hastalarında Simetrik veya Asimetrik Cerrahi Ö ÖZ ZE ET T A Am ma aç ç: : Simetrik ve asimetrik cerrahi yapılan primer ekzotropya hastalarında cerrahi sonuçları değerlendirmektir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Temmuz 2001-Ocak 2016 tarihleri arasında kliniğimiz Şaşılık ve Nörooftalmoloji Biriminde iki taraflı dış rektus geriletmesi (simetrik cerrahi) ve tek taraflı dış rektus geriletmesi ile iç rektus kısaltması (asimetrik cerrahi) yapılan primer ekzotropya hastalarının kayıtları incelendi. Simetrik (Grup 1) ve asimetrik (Grup 2) cerrahi hastalarındaki cerrahi sonuçlar ve etkileyen faktörler karşılaştırıldı. B Bu ul lg gu ul la ar r: : Grup 1 hastalarının 15 (%45)'i kadın, 18 (%55)'i erkek; Grup 2 hastalarının 25 (%56)'i kadın, 20 (%44)'si erkek idi. Cerrahi yaşı Grup 1 hastalarında 22,45±15,99 (5-63) yıl, Grup 2 hastalarında 19,58±8,61 (4-45) yıl bulundu. Grup 2 hastalarında anizometropi oranları, refraksiyon değerleri ve cerrahi öncesi kayma açıları daha yüksek, binoküler görme oranları daha düşük saptandı. İki grubun cerrahi miktarları ve cerrahi sonrası kayma açıları arasında istatistiksel anlamda fark bulunmadı. Cerrahi başarı Grup 1 hastalarının 30 (%90,9)'unda elde edilirken, daha büyük kayma açısına sahip Grup 2 hastalarının 36 (%80)'sında elde edildi. İki gruptaki binoküler görme artışı cerrahi öncesine göre anlamlı bulundu. S So on nu uç ç: : Ekzotopya hastalarında klinik özelliklerine göre seçilecek simetrik veya asimetrik cerrahi ile başarılı sonuçlar alınmaktadır.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Asimetrik cerrahi; ekzotropya; simetrik cerrahi A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : To evaluate surgical outcomes in patients with primary exotropia who had symmetric and asymmetric surgery. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : The records of the patients with primary exotropia who underwent bilateral lateral rectus recession (symmetric surgery) and unilateral lateral rectus recession with medial rectus resection (asymmetric surgery) were evaluated at Strabismus and Neuro-ophthalmology Department of our clinic between July 2001-January 2016. Surgical outcomes and influencing factors were compared in patients of symmetric (Group 1) and asymmetric (Group 2) surgical groups. R Re es su ul lt ts s: : Fifteen (45%) patients of Group 1 were women and 18 (55%) were men, whereas 25 (56%) patients in Group 2 were women and 20 (44%) were men. Age at surgery was 22.45±15.99 (5-63) years in Group 1 patients, and 19.58±8.61 (4-45) years in Group 2 patients. The rate of anisometropia, refraction values and preoperative deviation...

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

Cited by 21 publications

References 21 publications

Effect of Bilateral Lateral Rectus Recession in Intermittent Exotropia according to the Limbus Insertion Distance

Effect of Bilateral Lateral Rectus Recession in Intermittent Exotropia according to the Limbus Insertion Distance

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

Symmetric or Asymmetric Surgery in Cases with Primary Exotropia

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