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Kim and Lee: Surgical Outcomes of Modified Medial Rectus Resections in Recurrent Intermittent Exotropia
Original Article

Journal of the Korean Ophthalmological Society 2019; 60(11): 1098-1104.

Published online: 19 November 2019

DOI: https://doi.org/10.3341/jkos.2019.60.11.1098

Surgical Outcomes of Modified Medial Rectus Resections in Recurrent Intermittent Exotropia

Kwang Hyun Kim, MD, Joo Yeon Lee, MD, PhD

Department of Ophthalmology, Hallym University College of Medicine, Chuncheon, Korea.

Address reprint requests to Joo Yeon Lee, MD, PhD. Department of Ophthalmology, Hallym University Medical Center, #22 Gwanpyeong-ro 170beon-gil, Dongan-gu, Anyang 14068, Korea. Tel: 82-31-380-3834, Fax: 82-31-380-3833, ljy690725@daum.net

Received 21 March 2019       Revised 3 June 2019       Accepted 23 October 2019

©2019 The Korean Ophthalmological Society

The Korean Ophthalmological Society

(open-access):

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 evaluate the outcomes of modified medial rectus (MR) resection using a lowered amount of MR resection for recurrent exotropia after bilateral lateral rectus (LR) recessions.

Methods

Fifty-six patients, who underwent MR resection from 2003 to 2017 for recurrent exotropia after bilateral LR recessions, were included. MR resection was performed using modified MR resection with a smaller amount of resection than the standard of 4 mm resection at 20 prism diopters (PD) of exotropia. Postoperative surgical results at 1 month, 6 months, 1 year and 2 years were classified as a success (5 PD esotropia [ET]-10 PD exotropia [XT]), overcorrection (>5 PD ET), and undercorrection (>10 PD XT). The clinical factors affecting surgical results at postoperative 6 month and 2 years were also evaluated.

Results

The success rate was 78.2% at postoperative 1 month and 87.5% at postoperative 6 months. The overcorrection rate was 21.8% and the undercorrection rate was 0% at postoperative 1 month. At postoperative 6 months, the overcorrection rate decreased to 0% and the undercorrection rate was 12.5%. The success rate was 85.7% at postoperative 1 year and 66.6% at postoperative 2 years. There was no clinical factor affecting the surgical outcomes except the ocular alignment at postoperative 1 month. The deviation at postoperative 1 month was more esotropic in patients with success at postoperative 6 months and 2 years than that in patients with undercorrection (p < 0.05).

Conclusions

The modified MR resection showed favorable results of 87.5% at postoperative 6 months and 85.7% at 1 year. The angle of deviation at postoperative 1 month was an indicator of subsequent surgical outcomes.

Keywords: Medial rectus resection, Recurrent exotropia, Surgical results

Figures and Tables

Table 1

Modified surgical dose for recurrent exotropia after bilateral lateral rectus recessions

jkos-60-1098-i001

MR = medial rectus.

Table 2

Demographic features of the patients with recurrent exotropia

jkos-60-1098-i002

Values are presented as mean ± standard deviation or number (%).

PD = prism diopters.

Table 3

Surgical outcomes of the medial rectus recession for recurrent exotropia after bilateral lateral rectus recession

jkos-60-1098-i003

Values are presented as number (%).

Table 4

Comparison of clinical factors between success and undercorrection at postoperative 6 months and 2 years

jkos-60-1098-i004

Values are presented as mean ± standard deviation or number unless otherwise indicated.

M:F = male:female; LR = lateral rectus; PD = prism diopters; FCGX = fusion control grade of the exodeviation; POD = postoperative day.

*Unpaired t-test; †chi-square test.

Notes

Conflicts of Interest The authors have no conflicts to disclose.

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