Journal List > J Korean Ophthalmol Soc > v.50(7) > 1008316

J Korean Ophthalmol Soc. 2009 Jul;50(7):1093-1097. Korean.
Published online July 24, 2009.  https://doi.org/10.3341/jkos.2009.50.7.1093
Copyright © 2009 The Korean Ophthalmological Society
The Effect of Medial Rectus Resection in Reccurent Exotropia After Lateral Rectus Recession
Won Kyung Cho, MD,1 Se Yup Lee, MD,2 and Young Chun Lee, MD1
1Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
2Department of Ophthalmology, Keimyung University School of Medicine, Daegu, Korea.

Address reprint requests to Young Chun Lee, MD. Department of Ophthalmology, Uijongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, #65-1 Keumo-dong, Uijeongbu 480-717, Korea. Tel: 82-31-820-3116, Fax: 82-31-847-3418, Email: yclee@cmcnu.or.kr
Received November 10, 2008; Accepted May 06, 2009.

Abstract

Purpose

To investigate the effect of unilateral medial rectus resection in recurrent exotropia under 25 Prism Diopter after unilateral or bilateral lateral rectus recession.

Methods

A retrospective chart analysis was conducted for 21 patients who underwent unilateral medial rectus resection for recurrent exotropia under 25PD and uni- or bilateral lateral rectus recession for prior surgery of exotropia. The medial rectus was resected from 5.0 to 7.0 mm by 0.5 mm according to angle deviation at a distance. The postoperative deviated angle was checked at one week, three months and six months postoperatively to investigate the amount of corrected deviation per resected muscle.

Results

The average preoperative deviation was 20.57±3.37PD. We resected mean 6.1±0.62 mm of the medial rectus. At one week after the surgery, the postoperative deviated angle was 2.00±4.32PD, After six months it was 6.57±7.40PD, and there appeared to be an increase of deviation. Ten patients (48%) fused before surgery and 12 (57%) after surgery. The corrected deviation per resected muscle was 2.88±1.08PD.

Conclusions

Unilateral medial rectus resection is an effective surgical method for the treatment of recurrent exotropia under 25 PD after lateral rectus recession.

Keywords: Lateral rectus recession; Recurrent exotropia; Unilateral medial rectus resection

Tables


Table 1
Age and sex distribution at the first and second operation
Click for larger image


Table 2
Sensory status of Worth 4 Dot at near
Click for larger image


Table 3
Pre- and postoperative angle deviation at the first and second operation and the amount of rectus muscle recession or resection
Click for larger image


Table 4
Corrected prism diopter per resected medial rectus according to deviated angle
Click for larger image


Table 5
Amount of MR resection according to angle deviation and postoperative deviations
Click for larger image

References
1. Scott WE, Keech R, Mash AJ. The postoperative results and stability of exodeviations. Arch Ophthalmol 1981;99:1814–1818.
2. Hahm KH, Shin MC, Sohn MA. The change in deviation angle with time cource after surgical correction of intermittent exotropia. J Korean Ophthalmol Soc 2002;43:2214–2219.
3. Olitsky SE, Kelly C, Lee H, Nelson LB. Unilateral rectus resection in the treatment of undercorrected or recurrent strabismus. J Pediatr Ophthalmol Strabismus 2001;38:349–353.
4. Kim JY, Chang BL. The Effect of unilateral rectus recession in recurrent exotropia. J Korean Ophthalmol Soc 1995;36:2261–2265.
5. Kim SC, Kim MM. The efficacy of unilateral rectus resection in reoperation of strabismus. Korean J Ophthalmol 2003;44:904–910.
6. Chae SH, Chun BY, Kwon JY. The effect of unilateral medial rectus resection in patients with recurrent exotropia. Korean J Ophthalmol 2008;22:174–177.
7. Chun K, Rah S. The comparison of outcomes between lateral rectus muscle re-recession and medial rectus muscles resection in recurrent exotropia. Korean J Ophthalmol 2008;22:111–114.
8. Grin TR, Nelson LB. Large unilateral medial rectus muscle recession for the treatment of esotropia. Br J Ophthalmol 1987;71:377–379.
9. Olitsky SE. Early and late postoperative alignment following unilateral lateral rectus recession for intermittent exotropia. J Pediatr Ophthalmol Strabismus 1998;35:146–148.
10. Chang BL. Operative results in exotropia. J Korean Ophthalmol Soc 1983;24:729–734.
11. Lee JY, Choi DG. The clinical analysis of recurrence after surgical correction of intermittent exotropia. J Korean Ophthalmol Soc 2002;43:2220–2226.
12. Jampolsky A. Treatment of exodeviations. Trans New Orleans acad Ophthalmol 1986:201–234.
13. Stoller SH, Simon JW, Lininger LL. Bilateral lateral rectus recession for exotropia. A survival analysis. J Pediatr Ophthalmol Strabismus 1994;31:89–92.
14. Ryu JW, Lee SY, Lee YC. Result analysis according to surgical amount after unilateral lateral rectus recession in patients with exodeviation under 25PD. J Korean Ophthalmol Soc 2006;47:593–599.