Major article
Augmented bilateral lateral rectus recessions in basic intermittent exotropia

Presented as a poster at the 30th Annual Meeting of the American Association for Pediatric Ophthalmology and Strabismus, Washington, DC, March 27-31, 2004.
https://doi.org/10.1016/j.jaapos.2007.02.014Get rights and content

Purpose

To compare the outcomes of conventional surgery with the outcomes of surgeries using augmented amounts of symmetric lateral rectus recessions in the treatment of patients with basic intermittent exotropia.

Methods

One hundred seven patients were enrolled in this study; the patients were followed for more than 6 months. The study group was composed of 41 patients who had undergone conventional surgery, and 66 who had augmented surgery. The amount of recession in conventional surgery was determined according to Parks’ formula; the augmented amount ranged from 1.5 to 2.5 mm more per eye in augmented surgery.

Results

The success rate was 68.2% in subjects who had undergone augmented surgery, compared with the 43.9% observed in those who had undergone the conventional procedure (p = 0.01). The undercorrection rate was 53.7% in those who had undergone conventional surgery and 30.3% in those who had undergone augmented surgery (p = 0.02). The overcorrection rate was similar in the two groups (conventional, 2.4%; augmented, 1.5%).

Conclusions

The augmented formula may be preferable to the standard formula for patients undergoing symmetric surgery to correct basic intermittent exotropia.

Section snippets

Subjects and Methods

The medical records of 107 consecutive patients, 59 females and 48 males, who had undergone surgery for basic intermittent exotropia between June 1995 and July 2004 were retrospectively reviewed. The inclusion criteria were as follows: (1) intermittent exotropia; (2) “basic” type (the near deviation was within 10Δ of the distance deviation); (3) an absence of lateral incomitance of more than 10Δ; (4) patient over 4 years of age; (5) amblyopia; (6) no simultaneous oblique surgery; (7) no history

Results

Table 2 shows the characteristics of the conventional surgery and augmented surgery groups. There were no significant differences between the mean alignment, the follow-up period, or the age of the patients who had undergone either of the two surgical procedures (p = 0.23, p = 0.55, p = 0.06). The range of the follow-up period for patients who had conventional and augmented surgery was 6 to 39 months and 6 to 35 months, respectively.

On postoperative day 1, the success rate was 70.7% in those

Discussion

In the surgical management of exotropia, there is widespread agreement that an initial overcorrection is needed because there is a tendency toward a postoperative exotropic drift. Raab and Parks9 reported that an overcorrection of 10Δ to 20Δ provided the best outcome. Scott et al10 advised an overcorrection of between 4Δ and 14Δ. Moreover, good correlations between the initial and final measurements after surgery for intermittent exotropia have been reported by others.11, 12 In this study,

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The authors have no financial conflicts of interest to disclose.

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