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Treatment of Consecutive Exotropia: Unilateral Lateral Rectus Recession Combined With Medial Rectus Advancement or Resection.
MedLine Citation:
PMID:  24512646     Owner:  NLM     Status:  Publisher    
PURPOSE: Consecutive exotropia presents a difficult clinical problem, especially when previously recessed medial recti are to be strengthened. Surgical options include advancement, typically with a small resection, and resection alone.
METHODS: The authors retrospectively reviewed records of all patients who underwent a second two-muscle surgery on a single eye for consecutive exotropia. Patients with paralytic strabismus and those with less than 1 month of postoperative follow-up were excluded. In 2003, one of the authors began medial rectus resections without advancements in most cases, whereas a second author continued to perform advancements. Two treatment groups were thus reviewed.
RESULTS: Forty-two patients qualified for inclusion, including 23 for the resection group and 19 for the advancement group. Preoperative deviations were similar (P = .35, 95% confidence interval: -2.64 to 9.82). Postoperative deviations averaged 11.4 prism diopters (PD) in the resection group and 11.5 PD in the advancement group (P = .98, 95% confidence interval: -12.2 to 12.3). Forty-eight percent of the resection group and 63% of the advancement group achieved alignment within 10 PD of orthophoria (P = .33, 95% confidence interval: -9.0% to 39%).
CONCLUSIONS: Surgical results were favorable following both techniques. Although both techniques appear to be adequate, resection of previously recessed medial recti may be preferable because they allow use of standard surgical tables and avoid advancement of inflamed tissue into the palpebral fissure. [J Pediatr Ophthalmol Strabismus 20XX;XX:XX-XX.].
Deepak Mangla; John W Simon; Neeraj Mangla; Jitka Zobal-Ratner
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-2-12
Journal Detail:
Title:  Journal of pediatric ophthalmology and strabismus     Volume:  -     ISSN:  1938-2405     ISO Abbreviation:  J Pediatr Ophthalmol Strabismus     Publication Date:  2014 Feb 
Date Detail:
Created Date:  2014-2-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7901143     Medline TA:  J Pediatr Ophthalmol Strabismus     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1-4     Citation Subset:  -    
Copyright Information:
Copyright 2014, SLACK Incorporated.
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