J Korean Ophthalmol Soc > Volume 59(1); 2018 > Article
Journal of the Korean Ophthalmological Society 2018;59(1):60-66.
DOI: https://doi.org/10.3341/jkos.2018.59.1.60    Published online January 15, 2018.
Comparison between Modified Bilateral Lateral Rectus Recession and Augmented Unilateral Recession-resection for Convergence Insufficiency Exotropia.
Min Hwan Kim, Seok Hyeon Song, Hae Ri Yum
Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Korea. smile-ri@hanmail.net
눈모음부족형외사시에서 보정한 양안 외직근후전술과 증량한 단안 외직근후전술 및 내직근절제술의 수술 결과 비교
김민환⋅송석현⋅염혜리
건양대학교 의과대학 안과학교실
Correspondence:  Hae Ri Yum,
Email: smile-ri@hanmail.net
Received: 6 July 2017   • Revised: 17 October 2017   • Accepted: 13 December 2017
Abstract
PURPOSE
To compare the surgical outcomes between modified bilateral lateral rectus muscle (BLR) recession and augmented unilateral recession-resection (R&R) for the convergence insufficiency intermittent exotropia (IXT). METHODS: 37 patients with convergence insufficiency IXT were divided into two groups: 13 patients (underwent BLR recession) and 24 patients (underwent unilateral R&R). Success was defined as within 10 prism diopters (PD) at distance and near, and within 10 PD of the difference between them at postoperative 12 months. RESULTS: After the patch test, the preoperative distance deviation angle in the BLR group was 29.9 ± 8.4 PD, and the near deviation angle was 42.3 ± 9.7 PD; the difference between them was 12.5 ± 3.2 PD. In the R&R group, the preoperative distance deviation angle was 26.7 ± 5.8 PD, and the near deviation angle was 41.5 ± 7.4 PD; the difference between them was 14.8 ± 4.3 PD (p = 0.235, p = 0.987, and p = 0.123). At the 12-month follow-up in the BLR group, the distance angle was 3.8 ± 5.1 PD, and the near deviation angle was 4.9 ± 6.1 PD; the difference between them was 2.9 ± 5.9 PD. In the R&R group, the postoperative distance deviation angle was 4.7 ± 6.1 PD, and the near deviation angle was 7.9 ± 6.6 PD; the difference between them was 3.65 ± 5.1 PD (p = 0.708, p = 0.162, and p = 0.632, respectively). The surgical success rate did not differ significantly between groups at 12 months postoperatively (76.9%: BLR group and 70.8%: R&R group; p = 0.690). CONCLUSIONS: Modified BLR recession showed a similar surgical success rate to augmented unilateral R&R, and was effective in reducing both distance and near exodeviation, and in decreasing the difference between distance and near deviation in convergence insufficiency IXT.
Key Words: Bilateral lateral rectus recession;Convergence insufficiency type;Intermittent exotropia;Recession and resection;Surgical outcome


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