Session: Poster session B

Concurrent recessions of lateral and medial rectus for prevention of consecutive esotropia in intermittent exotropia

Introduction

If consecutive esotropia (CET) occurs after intermittent exotropia (IX(T)) surgery, it raises concerns among patients and their parents due to tenacious esodeviation and diplopia. We performed concurrent recessions of lateral rectus (LR) and medial rectus (MR) muscle in intermittent exotropia and aimed to observe the preventive effect against consecutive esotropia (CET).

Methods

Total 30 patients were included in this study. Group A (n=13) underwent concurrent LR and MR recessions for IX(T) and group B (n=17) underwent secondary MR recession for CET that occurred after bilateral LR recessions or unilateral LR recession with MR resection for IX(T). In group A, 3 to 5 mm of MR recession was performed with LR recession after confirming strong tension of MR by forced duction test and spring-back balance test during IX(T) surgery. All patients were followed up more than a year (12-96 months) after surgery to analyze the development of CET and the recurrence of IX(T).

Results

There were no significant differences in sex ratio, age at IX(T) surgery, and preoperative exotropia angle between two groups(P>0.05). The deviation angles for groups A and B(after IX(T) surgery) were -2.15?, +4.83? at 1 month, -2.50?, +13.69? at 6 months, -3.45?, +19.31? at 1 year, -7.20?, +17.63? at 2 years, and -5.33?, +23.25? at 3 years, respectively, indicating a significant difference in the occurrence of esotropia(p<0.05). CET was developed in only 1 patient of group A. After correction of CET in group B, there was no significant difference in tendency for IX(T) recurrence between two groups(p>0.05).

Conclusions

When CET development is expected due to strong tension of the MR, concurrent recessions of the LR and MR demonstrated to effectively prevent CET while reducing the number of surgeries.