J Korean Ophthalmol Soc > Volume 60(11); 2019 > Article
Journal of the Korean Ophthalmological Society 2019;60(11):1098-1104.
DOI: https://doi.org/10.3341/jkos.2019.60.11.1098    Published online November 15, 2019.
Surgical Outcomes of Modified Medial Rectus Resections in Recurrent Intermittent Exotropia.
Kwang Hyun Kim, Joo Yeon Lee
Department of Ophthalmology, Hallym University College of Medicine, Chuncheon, Korea. ljy690725@daum.net
양안 외직근후전술 후 재발한 간헐외사시에서 보정한 내직근절제술의 수술 결과
김광현 · 이주연
한림대학교 의과대학 안과학교실
Correspondence:  Joo Yeon Lee,
Email: ljy690725@daum.net
Received: 21 March 2019   • Revised: 3 June 2019   • Accepted: 23 October 2019
Abstract
PURPOSE
To evaluate the outcomes of modified medial rectus (MR) resection using a lowered amount of MR resection for recurrent exotropia after bilateral lateral rectus (LR) recessions. METHODS: Fifty-six patients, who underwent MR resection from 2003 to 2017 for recurrent exotropia after bilateral LR recessions, were included. MR resection was performed using modified MR resection with a smaller amount of resection than the standard of 4 mm resection at 20 prism diopters (PD) of exotropia. Postoperative surgical results at 1 month, 6 months, 1 year and 2 years were classified as a success (5 PD esotropia [ET]-10 PD exotropia [XT]), overcorrection (>5 PD ET), and undercorrection (>10 PD XT). The clinical factors affecting surgical results at postoperative 6 month and 2 years were also evaluated. RESULTS: The success rate was 78.2% at postoperative 1 month and 87.5% at postoperative 6 months. The overcorrection rate was 21.8% and the undercorrection rate was 0% at postoperative 1 month. At postoperative 6 months, the overcorrection rate decreased to 0% and the undercorrection rate was 12.5%. The success rate was 85.7% at postoperative 1 year and 66.6% at postoperative 2 years. There was no clinical factor affecting the surgical outcomes except the ocular alignment at postoperative 1 month. The deviation at postoperative 1 month was more esotropic in patients with success at postoperative 6 months and 2 years than that in patients with undercorrection (p < 0.05). CONCLUSIONS: The modified MR resection showed favorable results of 87.5% at postoperative 6 months and 85.7% at 1 year. The angle of deviation at postoperative 1 month was an indicator of subsequent surgical outcomes.
Key Words: Medial rectus resection;Recurrent exotropia;Surgical results


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