Outcome of unilateral lateral rectus recession and medial rectus resection in primary exotropiaReport as inadecuate




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BMC Research Notes

, 6:257

First Online: 08 July 2013Received: 25 November 2012Accepted: 03 July 2013DOI: 10.1186-1756-0500-6-257

Cite this article as: Saleem, Q.A., Cheema, A.M., Tahir, M.A. et al. BMC Res Notes 2013 6: 257. doi:10.1186-1756-0500-6-257

Abstract

BackgroundThe purpose of this study was to measure the success rate of unilateral lateral rectus recession and medial rectus resection in primary exotropia.

MethodsThis is an interventional case series of 55 patients with primary exotropia degree of deviation 15–85 PD, above the age of 5 years. Patients were treated in the Department of Ophthalmology, Jinnah Postgraduate Medical Center, Karachi, Pakistan, during the period of July 2009 to March 2010. All the patients underwent surgical procedure i.e., lateral rectus muscle recession maximum up to 10 mm and medial rectus muscle resection up to 6 mm of one eye, according to the Park’s method. Surgery was done based on prism cover test measurements obtained at 6 m with appropriate optical correction in place. Patients were re evaluated at one day, one month, two months and six months post operatively. Final outcome was considered at the end of six months at which achievement of ≤10 PD of exotropia was the success. Data was analyzed on SPSS version 17.0.

ResultsWe obtained success ≤10 PD in 42 out of 55 patients 76.4% and 13 out of 55 patients 23.6% did not meet our criteria for surgical success >10 PD. Analysis of success with the type of primary exotropia showed that success was achieved in 22 out of 24 cases of intermittent type 91.6% and 20 out of 31 cases of constant type 64.5%P Value 0.019. The highest percentage of success was achieved in patients with the pre-operative deviation of ≤70 PD i.e., 93.3% 42 out of 45 cases, while none of the patients with the pre-operative deviation of >70 PD 10 out of 10 cases achieved the criteria for success.

ConclusionWe conclude that pre-operative deviation is one of the strongest predictor for favorable surgical outcome. Therefore, eliminating the factors causing error in the correct determination of pre-operative deviation should improve the success and predictability of the surgical outcome. Despite the obstacles in the surgical management of strabismus, our results are encouraging.

KeywordsUnilateral recession Resection Primary exotropia Prism Diopter PD Electronic supplementary materialThe online version of this article doi:10.1186-1756-0500-6-257 contains supplementary material, which is available to authorized users.

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Author: Quratul Ain Saleem - Alyscia M Cheema - Muhammad Ali Tahir - Arif Rabbani Dahri - Tahir M Sabir - Javed H Niazi

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