The aim of this study was to compare surgical motor and sensory outcomes of unilateral versus bilateral lateral rectus recessions in children with small angle intermittent exotropia. This was a retrospective study of 55 patients; 28 bilateral and 27 unilateral surgery. Both groups were similar at baseline except that bilateral cases had greater angles of deviation. For bilateral recessions, mean surgery was 5.5 ±0.6mm per muscle or 0.53 ±0.06mm/PD – range 5-7mm per muscle. For unilateral recessions, mean surgery was 7.5 ±0.4mm per muscle or 0.41 ±0.04mm/PD – range 5-8.5mm per muscle. At follow-up of 12 months, 13/28 had a successful outcome with bilateral recessions (46%) versus 19/27 for unilateral recessions (70%). There was a statistically significant trend toward a higher fail rate with bilateral recessions. No specific factors were found to be associated with poor outcome. There was no lateral incomitance >10PD at follow-up. Risk of loss of central fusion was low. The authors acknowledge the small sample size and retrospective nature of this study. They discuss the advantages of unilateral surgery and recommend a prospective trial of surgical options.
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Bilateral versus unilateral recession outcomes for intermittent exotropia
Reviewed by Fiona Rowe
CONTRIBUTOR
Fiona Rowe (Prof)
Institute of Population Health, University of Liverpool, UK.
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