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Comparison of different surgery procedures for convergence insufficiency-type intermittent exotropia in children
  1. Bing Wang,
  2. Lihua Wang,
  3. Qi Wang,
  4. Meiyu Ren
  1. Department of Ophthalmology, Shandong Provincial Hospital affiliated to Shandong University, Jinan, Shandong, People's Republic of China
  1. Correspondence to Dr Lihua Wang, Department of Ophthalmology, Shandong Provincial Hospital affiliated to Shandong University, No. 324, Jingwu Road, Jinan, Shandong 250021, People's Republic of China; wang_glasses{at}aliyun.com

Abstract

Aims To compare prospectively the surgical outcomes of different surgery procedures for convergence insufficiency (CI)-type intermittent exotropia (IXT) in children.

Methods Forty-five children with CI-type IXT were included in this prospective surgical study with 6 months follow-up. According to the different surgical procedures, all children were randomly divided into three groups: the unilateral medial rectus resection (UMR) group (15 cases), the bilateral medial rectus resections (BMR) group (14 cases) and the improved unilateral recession-resection (R&R) group (16 cases). In the UMR and BMR groups, the medial rectus resection(s) were based on the distance exodeviation. In the R&R group, UMR was based on the near exodeviation while lateral rectus recession was based on the distance exodeviation. A successful surgical alignment was defined as the distant deviation in the primary gaze to be between ≤10 prism dioptres (PD) of exophoria/tropia and ≤5 PD of esophoria/tropia. The success rate, the preoperative and postoperative deviations at distance and near and near-distance differences among groups were compared.

Results At the last follow-up of 6 months, the success rate in the R&R (87.5%) group was significantly higher than those in the UMR (13.3%) and BMR (42.9%) groups (p=0.000 and 0.008); the mean exodeviations at distance and near in the R&R group were significantly different from those in the UMR and BMR groups (p=0.000 and 0.001); there were no significant differences in the mean near-distance differences between the R&R group and the other two groups (p>0.05).

Conclusions The improved R&R procedure in which medial rectus resection based on the near deviation with lateral rectus recession based on the distant deviation has a better alignment than the UMR and BMR surgeries for the treatment of children with CI-type IXT. All the UMR, BMR and improved R&R surgery can reduce near-distance differences in children with CI-type IXT.

  • Child health (paediatrics)
  • Muscles
  • Treatment Surgery

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