Modification of surgery to reduce consecutive ET

1 April 2019 | Fiona Rowe (Prof) | EYE - Paediatrics, EYE - Strabismus

Surgical treatment for recurrent exotropia (ET) predominantly depends on the primary surgery. Modification of surgical dose may be required in secondary procedures. The aim of this study was to compare surgical outcomes of modified and conventional secondary surgery using lateral rectus (LR) recession and medial rectus (MR) resection for exotropia after primary surgery of unilateral LR recession and MR resection. This was a retrospective study of 36 patients. Preoperative angle was 22.8±5.31PD for the conventional surgery group with success rate of 78.9% by month one follow-up, final success rate of 73.7%, recurrence rate of 0% and 26.3% reoperative rate or need for prism glasses postoperatively. Preoperative angle was 24.2±7.03PD for the modified surgery group with success rate of 100% by month one follow-up, final success rate of 82.4%, recurrence rate of 17.6% and 0% reoperative rate or need for prism glasses postoperatively. Mean follow-up after the second procedure was 73.3±41.3 months for conventional surgery and 71.8±32 months for modified surgery. Overcorrection occurred more for conventional surgery and consecutive esotropia occurred more for conventional surgery. The authors recommend dose modification for secondary surgery.