KMID : 0360220180590010060
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Journal of the Korean Ophthalmological Society 2018 Volume.59 No. 1 p.60 ~ p.66
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Comparison between Modified Bilateral Lateral Rectus Recession and Augmented Unilateral Recession-resection for Convergence Insufficiency Exotropia
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Kim Min-Hwan
Song Seok-Hyeon Yum Hae-Ri
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Abstract
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Purpose: To compare the surgical outcomes between modified bilateral lateral rectus muscle (BLR) recession and augmented unilateral recession-resection (R&R) for the convergence insufficiency intermittent exotropia (IXT).
Methods: 37 patients with convergence insufficiency IXT were divided into two groups: 13 patients (underwent BLR recession) and 24 patients (underwent unilateral R&R). Success was defined as within 10 prism diopters (PD) at distance and near, and within 10 PD of the difference between them at postoperative 12 months.
Results: After the patch test, the preoperative distance deviation angle in the BLR group was 29.9 ¡¾ 8.4 PD, and the near deviation angle was 42.3 ¡¾ 9.7 PD; the difference between them was 12.5 ¡¾ 3.2 PD. In the R&R group, the preoperative distance deviation angle was 26.7 ¡¾ 5.8 PD, and the near deviation angle was 41.5 ¡¾ 7.4 PD; the difference between them was 14.8 ¡¾ 4.3 PD (p = 0.235, p = 0.987, and p = 0.123). At the 12-month follow-up in the BLR group, the distance angle was 3.8 ¡¾ 5.1 PD, and the near deviation angle was 4.9 ¡¾ 6.1 PD; the difference between them was 2.9 ¡¾ 5.9 PD. In the R&R group, the postoperative distance deviation angle was 4.7 ¡¾ 6.1 PD, and the near deviation angle was 7.9 ¡¾ 6.6 PD; the difference between them was 3.65 ¡¾ 5.1 PD (p = 0.708, p = 0.162, and p = 0.632, respectively). The surgical success rate did not differ significantly between groups at 12 months postoperatively (76.9%: BLR group and 70.8%: R&R group; p = 0.690).
Conclusions: Modified BLR recession showed a similar surgical success rate to augmented unilateral R&R, and was effective in reducing both distance and near exodeviation, and in decreasing the difference between distance and near deviation in convergence insufficiency IXT.
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KEYWORD
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Bilateral lateral rectus recession, Convergence insufficiency type, Intermittent exotropia, Recession and resection, Surgical outcome
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