Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus · 2019
Combined resection-recession in true divergence excess sensory exotropia.
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Bhaskaran Karthika, Shashni Adarsh Kumar, Sharma Pradeep, Saxena Rohit, Phuljhele Swati
Аннотация
PURPOSE: To assess the effect of combined resection and recession on the same lateral rectus muscle in patients with true divergence excess sensory exotropia.
METHODS: Patients were divided into two groups. One group of patients underwent combined resection-recession of the lateral rectus muscle in one eye (LR group); the other group, with exodeviation of >40Δ for distance underwent additional ipsilateral medial rectus resection (LR + MR group). Postoperative measurements were taken at 1 week, 1 month, and 3 months.
RESULTS: Eleven patients were included in the study (mean age, 23.5 ± 6.7 years): 7 in the LR group and 4 in the LR + MR group. For the LR group, mean preoperative deviation was 35.7Δ ± 3.5Δ at distance and 16.3Δ ± 3.9Δ at near. The mean near-distance disparity (NDD) was 11.4Δ ± 2.7Δ. The mean lateral rectus recession was 8.6 ± 1.1 mm: the mean resection, 4.3 ± 0.5 mm. At 3 months, mean deviation at distance was 8.3Δ ± 2.1Δ; at near, 3.1Δ ± 1.6Δ (P = 0.01). The NDD was 5.7Δ ± 2.7Δ (P = 0.01). For the LR + MR group, mean preoperative deviations at distance was 65.0Δ ± 12.9Δ; at near, 35.0Δ ± 12.2Δ. The mean NDD was 30.0Δ ± 4.0Δ. Mean lateral rectus recession was 9.5 ± 1.8 mm; the mean resection, 4.8 ± 0.8 mm. The mean medial rectus resection was 5.5 ± 0.6 mm. At 3 months, mean deviation at distance was 8.3Δ ± 2.1Δ; at near, 3.1Δ ± 1.6Δ (P = 0.06). The NDD was 5.7Δ ± 2.7Δ (P = 0.06).
CONCLUSIONS: In our study combined resection and recession of the same lateral rectus muscle in patients with divergence excess sensory exotropia significantly reduced the NDD, with no adverse outcomes.
METHODS: Patients were divided into two groups. One group of patients underwent combined resection-recession of the lateral rectus muscle in one eye (LR group); the other group, with exodeviation of >40Δ for distance underwent additional ipsilateral medial rectus resection (LR + MR group). Postoperative measurements were taken at 1 week, 1 month, and 3 months.
RESULTS: Eleven patients were included in the study (mean age, 23.5 ± 6.7 years): 7 in the LR group and 4 in the LR + MR group. For the LR group, mean preoperative deviation was 35.7Δ ± 3.5Δ at distance and 16.3Δ ± 3.9Δ at near. The mean near-distance disparity (NDD) was 11.4Δ ± 2.7Δ. The mean lateral rectus recession was 8.6 ± 1.1 mm: the mean resection, 4.3 ± 0.5 mm. At 3 months, mean deviation at distance was 8.3Δ ± 2.1Δ; at near, 3.1Δ ± 1.6Δ (P = 0.01). The NDD was 5.7Δ ± 2.7Δ (P = 0.01). For the LR + MR group, mean preoperative deviations at distance was 65.0Δ ± 12.9Δ; at near, 35.0Δ ± 12.2Δ. The mean NDD was 30.0Δ ± 4.0Δ. Mean lateral rectus recession was 9.5 ± 1.8 mm; the mean resection, 4.8 ± 0.8 mm. The mean medial rectus resection was 5.5 ± 0.6 mm. At 3 months, mean deviation at distance was 8.3Δ ± 2.1Δ; at near, 3.1Δ ± 1.6Δ (P = 0.06). The NDD was 5.7Δ ± 2.7Δ (P = 0.06).
CONCLUSIONS: In our study combined resection and recession of the same lateral rectus muscle in patients with divergence excess sensory exotropia significantly reduced the NDD, with no adverse outcomes.