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This is a retrospective study of 186 children who underwent resection-recession (RR) or plication-recession (PR) for intermittent exotropia between January 2008 and July 2016, from Seoul Korea, with a minimum follow-up of two years. Standard fornix based approach was used by a single surgeon, with an augmented surgical dosage by 1-1.5mm over the original surgical for the plication technique. Surgical outcomes at year two were classified into two groups: success defined as esodeviation < or equal to 5PD to exodeviation of < equal to 10PD; failure defined as overcorrection esodeviation > or equal to 5PD and under correction or recurrence of exodeviation > or equal to 10PD. One hundred and fourteen had RR and 72 had PR. The duration of exodrift were longer in the PR group than in the RR group. The surgical success at postoperative year two was 55.3% in the RR group and 27.8% in the PR group (p<0.001) the amount of initial overcorrection was associated with successful outcomes in both groups. The authors concluded that the RR group presented with better outcomes than PR group and amount of initial overcorrection was important to achieve favourable results in this condition. Limitations of the study include the retrospective nature of the study, small number of cohort of patients, only alternate prism cover test was used for distance and near deviations, wide age range and all types of intermittent exotropia were grouped together in the study. 

Long-term outcomes following resection-recession (RR) versus plication-recession (PR) in children with intermittent exotropia.
Lee H-J, Kim S-J.
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Jonathan Chan

Royal Hallamshire Hospital, Sheffield, UK.

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