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Hwang, Lee, and Lee: Change of Strabismus Angle and Deviation After Unilateral or Bilateral Lateral Rectus Recession in Exotropia
Original Article

J Korean Ophthalmol Soc 2011;52(1):60-66.

Published online: 7 September 2011

DOI: https://doi.org/10.3341/jkos.2011.52.1.60

Change of Strabismus Angle and Deviation After Unilateral or Bilateral Lateral Rectus Recession in Exotropia

Kyu Yeon Hwang, MD1, Se Yup Lee, MD2, Young Chun Lee, MD1

1Department of Ophthalmology, The Catholic University of Korea School of Medicine, Seoul, Korea

2Department of Ophthalmology, Keimyung University School of Medicine, Daegu, Korea

Address reprint requests to Young Chun Lee, MD Department of Ophthalmology, Uijeongbu St. Mary's Hospital #65-1 Geumo-dong, Uijeongbu 480-717, Korea Tel: 82-31-820-3116, Fax: 82-31-847-3418, E-mail: yclee@cmcnu.or.kr

Received 26 February 2010       Revised 16 August 2010       Accepted 17 November 2010

Copyright © 2011 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To compare the changes in strabismus angle and deviation between two groups: a bilateral lateral rectus recession (Group 1) and a unilateral lateral rectus recession in exotropia (Group 2).

Methods

A retrospective survey was conducted on 198 patients who had received exotropia surgery in our ophthalmology clinic from September 2003 to April 2007. A total of 116 patients were in Group 1, and 82 patients were in Group 2.
Unilateral lateral rectus recession was performed on patients under 25 PD, and bilateral lateral rectus recession was performed on patients above 25 PD. A case of less than 4 PD esodeviation and less than 10 PD exodeviaton was defined as a success and any other case as a failure at the 1-year follow-up visit.

Results

The average deviations of the first postoperative month and the first postoperative year were −1.96 D ± 4.75, 2.5 D ± 7.82 for Group 1 and 0.77 D ± 2.87, 5.94 D ± 3.38 for Group 2. Revealing statistical significance between the 2 Groups: Group 1 had 30 failure cases (25.9%) and their 1 postoperative year average deviation was 5.42 D ± 13.97, while Group 2 showed 24 failure cases (29.3%) and their 1-postoperative-year average deviation was 13.0–79 ± 3.04. Group 1 had less strabismus angle and a greater standard deviation than Group 2, as Group 1 had more overcorrection. Among the 30 failure cases of Group 1, 9 were overcorrected and 21 were undercorrected, but all 24 failure cases in Group 2 were undercorrected.

Conclusions

The strabismus angle after lateral rectus recession showed a wider variation and a larger difference in bilateral lateral rectus recession than in the unilateral lateral rectus recession.

Keywords: Bilateral lateral rectus recession, Deviation angle, Exotropia, Unilateral lateral rectus recession

References

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Figure 1.
Change in postoperative deviation angle of Group 1 and Group 2 in exotropia.
jkos-52-60f1.tif
Figure 2.
Histogram of angle deviation.
jkos-52-60f2.tif
Table 1.
Clinical characteristics of patients
Group 1* Group 2† p value
Number 116 82
Sex
  male 45 35
  Female 71 47
Age
  Mean ± SD 6.44 ± 2.33 6.98 ± 2.19 0.104
  Range 3–14 3–13
Preop deviation (PD‡)
  Mean ± SD 29.18 ± 4.71 20.95 ± 3.26 0.000
  Range 25–40 16–24

* Group 1 = Bilateral lateral rectus recession

† Group 2 = Unilateral lateral rectus recession

‡ PD = Prism diopter.

Table 2.
Comparison of angle of deviation
Group (N*) Postoperative Follow up Angle of deviation (Mean±SD) (PD†)
Group 1‡ Group 2§ p value
1 week −1.97 ± 4.75 0.77 ± 2.87 0.000
1 year 2.5 ± 7.82 5.94 ± 3.38 0.000
Success (144)
1 week −1.67 ± 4.27 0.31 ± 2.80 0.002
1 year 1.36 ± 3.32 2.93 ± 3.80 0.010
Failure (54)
1 week −2.85 ± 5.91 1.83 ± 3.23 0.001
1 year 5.42 ± 13.97 13.79 ± 3.04 0.008

* N = number of patients

† PD = prism diopter

‡ Group 1 = bilateral lateral rectus recession

§ Group 2 = unilateral lateral rectus recession.

Table 3.
Comparison of success rate between Group 1 and Group 2 in postoperative 1 year
Group (N*) Deviation angle (PD†) No. of patient (%)
Group 1‡ (N = 116) Group 2§ (N = 82)
Success (144) 86 (74.1%) 58 (70.7%)
Failure 30 (25.9%) 24 (29.3%)
  Overcorrection (10) >10 PD esodeviation 8 (6.9%) 0
4–10 PD esodeviation 2 (1.7%) 0
  Undercorrection (44) 10–19 PD exodeviation 7 (6.0%) 20 (24.4%)
>20 PD exodeviation 13 (11.2%) 4 (4.9%)

* N = Number of patients

† PD = prism diopter

‡ Group 1 = bilateral lateral rectus recession

§ Group 2 = Unilateral lateral rectus recession.

Table 4.
Coefficient of variation at each follow-up period
Group (N*) 1 week 1 month 3 month 6 month 1 year 1.5 year 2 year
  Group 1† 241.5 372.9 605.4 393.7 312.7 282.5 253.1
  Group 2‡ 375.5 81.9 86.8 72.1 57.0 53.1 48.1
Success (144)
  Group 1† (86) 255.1 336.5 444.6 513.9 244.2 204.7 194.7
  Group 2‡ (58) 901.7 222.4 188.8 167.2 129.8 124.32 83.95
Failure (54)
  Group 1† (30) 207.6 367.8 655.2 255.3 257.6 216.0 206.9
  Group 2‡ (24) 176.0 46.8 51.6 31.4 22.0 19.2 17.3

Coefficient of variation = standard deviation / mean × 100 (%).

* N = Number of patients

† Group 1 = bilateral lateral rectus recession

‡ Group 2 = unilateral lateral rectus recession.

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