COMPARISON OF LONG TERM SURGICAL OUTCOMES OF BILATERAL LATERAL RECTUS RECESSION VERSUS UNILATERAL RECESSION–RESECTION FOR BASIC TYPE INTERMITTENT EXOTROPIA

Dr Vipin Rana; Dr Anirudh Singh; Dr Atul Gupta; Dr Vijay Mathur

Volume : VII, Issue : V, May - 2017

COMPARISON OF LONG TERM SURGICAL OUTCOMES OF BILATERAL LATERAL RECTUS RECESSION VERSUS UNILATERAL RECESSION–RESECTION FOR BASIC TYPE INTERMITTENT EXOTROPIA

Dr Vipin Rana, Dr Anirudh Singh, Dr Atul Gupta, Dr Vijay Mathur

Abstract :

PURPOSE: Comparison of the long–term surgical outcomes of bilateral lateral rectus recession (BLR) versus unilateral lateral rectus recession–medial rectus resection (RR) in treatment of basic type intermittent exotropia. DESIGN:. Prospective randomized comparative clinical trial. METHODS: 199 patients of basic type intermittent exotropia were enrolled in this study. Patients were assigned randomly to two groups, those who underwent bilateral lateral rectus recessions (BLR group) and those who underwent lateral rectus recession–medial rectus resection (RR group). Surgical outcomes were grouped according to postoperative angle of deviation as success (esophoria/ tropia < 5 PD to exophoria/tropia < 10 PD), overcorrection (esophoria/tropia > 5 PD) and undercorrection/recurrence (exophoria/tropia >10 PD) and were compared between the BLR group and the RR group at postoperative 1 day, 1 month, 6 months, 1 year, and 2 years. RESULTS: Out of 199 patients, 82 underwent BLR surgery whereas 117 underwent RR surgery. The mean age of onset in BLR group was 38.50 ± 1.47 months and in RR group it was 39.18 ±1.33 months. The final outcome at end of 2 years was significantly different between the groups, demonstrating a higher success rate in the BLR group than in the RR group (85.4 % versus 69.2%, p value < .05). CONCLUSION: BLR surgery is more effective than RR surgery in the long term for the basic type of intermittent exotropia as in RR group there are more chances of recurrence of exotropia.