J Korean Ophthalmol Soc > Volume 60(2); 2019 > Article
Journal of the Korean Ophthalmological Society 2019;60(2):169-175.
DOI: https://doi.org/10.3341/jkos.2019.60.2.169    Published online February 15, 2019.
Short-term Surgical Outcomes of Rectus Muscle Plication and Resection in Intermittent Exotropia.
Jung Woo Lee, Hoon Dong Kim, So Young Kim
Department of Ophthalmology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea. ophdrkim@schmc.ac.kr
간헐외사시 환자에서 겹침술과 절제술의 단기 수술효과 비교
이정우⋅김훈동⋅김소영
순천향대학교 의과대학 천안병원 안과학교실
Correspondence:  So Young Kim,
Email: ophdrkim@schmc.ac.kr
Received: 30 August 2018   • Revised: 27 September 2018   • Accepted: 18 January 2019
Abstract
PURPOSE
To evaluate the efficacy and safety of medial rectus muscle plication compared to resection, coupled with antagonist muscle recession, as treatments for intermittent exotropia (IXT). METHODS: We retrospectively reviewed the charts of IXT patients treated by a single surgeon and followed-up for at least 6 months between September 2016 and February 2017. The patients were divided into three groups: a bilateral lateral rectus muscle recession (BLR) group, a unilateral lateral rectus recession with medial rectus plication (R&P) group, and a unilateral lateral rectus recession with medial rectus resection (R&R) group. Serial changes in ocular alignment at 4–24 weeks after surgery were compared among the groups. In addition, the operative times were assessed. RESULTS: We included 119 patients (mean age 6.65 ± 2.79 years). The preoperative exodeviation was 29.81 ± 7.31 prism diopters (PDs) and did not differ among the groups. The R&P group exhibited significantly less postoperative deviation than the BLR group. The operative time was significantly less for the R&P group (25.77 ± 9.29 minutes) than the R&R group (28.97 ± 5.74 minutes). The success rates were identical among groups at 6 months; no severe adverse events were recorded apart from one case of dellen that improved after application of a topical agent. CONCLUSIONS: Plication may reduce the risk for anterior segment ischemia to a level lower than the risks associated with other procedures, and also facilitate reoperation if necessary. We found that R&P took less time but had success rate similar to BLR and R&R. Thus, medial rectus muscle plication for IXT patients is a valuable alternative procedure when the external rectus muscle requires strengthening.
Key Words: Exotropia;Surgical outcomes;Plication;Resection


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