This study investigates the success rate and dose response of bilateral lateral rectus muscle recessions (BLL) and bilateral lateral rectus muscle recessions plus unilateral medial rectus resection (LMR) on basic type infantile exotropia of 20–45PD. This was a retrospective review of 44 patients with mean age of 12.6 ±11.5 years (BLL) and 10.5 ±9.8 years (LMR). There was no significant difference between groups for sex, age at surgery, angle at near and distance, and visual acuity. At 2–4 weeks postoperative, 16.6% had residual exotropia and 5 with consecutive esotropia >10PD in the BLL group vs 3.8% with residual exotropia and two cases of consecutive esotropia <10PD in the LMR group. Median follow-up was 17.88 ±7.57 months (BLL) and 22.31 ±13.76 months (LMR). Successful motor outcomes at near and distance, were 70.5% (BLL) and 84.6% (LMR). Mean postoperative deviation at distance was 5.5 ±8.2PD (BLL) and 2.5 ±5.66PD (LMR). Orthophoria was achieved in 11% (BLL) and 65% (LMR) which was significantly different. Surgical effect was also significant: 1.82 ±0.58PD/mm (BLL) vs 2.72 ±0.72PD/mm (LMR). The authors acknowledge the limitations of this study with retrospective design, small sample size and lack of randomisation.
Infantile exotropia surgical outcomes
Reviewed by Fiona Rowe
3-muscle surgery for large and medium angle infantile exotropia.
CONTRIBUTOR
Fiona Rowe (Prof)
Institute of Population Health, University of Liverpool, UK.
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