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KMID : 0360220190600020169
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Journal of the Korean Ophthalmological Society
2019 Volume.60 No. 2 p.169 ~ p.175
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Short-term Surgical Outcomes of Rectus Muscle Plication and Resection in Intermittent Exotropia
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Lee Jung-Woo
Kim Hoon-Dong
Kim So-Young
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Abstract
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Purpose: To evaluate the efficacy and safety of medial rectus muscle plication compared to resection, coupled with antagonist muscle recession, as treatments for intermittent exotropia (IXT).
Methods: We retrospectively reviewed the charts of IXT patients treated by a single surgeon and followed-up for at least 6 months between September 2016 and February 2017. The patients were divided into three groups: a bilateral lateral rectus muscle recession (BLR) group, a unilateral lateral rectus recession with medial rectus plication (R&P) group, and a unilateral lateral rectus recession with medial rectus resection (R&R) group. Serial changes in ocular alignment at 4-24 weeks after surgery were compared among the groups. In addition, the operative times were assessed.
Results: We included 119 patients (mean age 6.65 ± 2.79 years). The preoperative exodeviation was 29.81 ± 7.31 prism diopters (PDs) and did not differ among the groups. The R&P group exhibited significantly less postoperative deviation than the BLR group. The operative time was significantly less for the R&P group (25.77 ± 9.29 minutes) than the R&R group (28.97 ± 5.74 minutes). The success rates were identical among groups at 6 months; no severe adverse events were recorded apart from one case of dellen that improved after application of a topical agent.
Conclusions: Plication may reduce the risk for anterior segment ischemia to a level lower than the risks associated with other procedures, and also facilitate reoperation if necessary. We found that R&P took less time but had success rate similar to BLR and R&R. Thus, medial rectus muscle plication for IXT patients is a valuable alternative procedure when the external rectus muscle requires strengthening.
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KEYWORD
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Exotropia, Surgical outcomes, Plication, Resection
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