scholarly journals Early Results of Slanted Recession of the Lateral Rectus Muscle for Intermittent Exotropia with Convergence Insufficiency

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Bo Young Chun ◽  
Kyung Min Kang
Keyword(s):  
Rectus Muscle ◽  
Lateral Rectus ◽  
Mean Deviation ◽  
Intermittent Exotropia ◽  
Convergence Insufficiency ◽  
Lateral Rectus Muscle ◽  
Early Results ◽  
Distance Difference ◽  
The Mean

The aim of this study was to evaluate the efficacy of slanted recession of the lateral rectus muscle for intermittent exotropia with convergence insufficiency. This prospective study included 31 patients who underwent slanted lateral rectus recession for intermittent exotropia with convergence insufficiency between June 2010 and June 2012. Following parameters were recorded and analyzed: patient sex, age, preoperative and postoperative near and distance ocular alignment, and changes in stereopsis. The mean age of the patients was 9.2 years. The preoperative mean deviation angle was 32.4 PD at distance and 43.4 PD at near. After 6 months, slanted lateral rectus recession reduced the deviation angles to 2 PD at distance and 3.4 PD at near. In addition, the mean difference between distance and near deviation angles was significantly reduced from 11 PD to 1.4 PD at 6 months postoperatively. Slanted lateral rectus recession for intermittent exotropia with convergence insufficiency in children successfully reduced the distance and near exodeviations and the near-distance difference without increasing the risk of long-term postoperative esotropia or diplopia.

scholarly journals New Modification of Vertical Muscle Transposition to Enhance Abducting Force in Sixth Nerve Palsy

2021 ◽  
Author(s):  
Santa Heede ◽  
Irina Kovalevskaya ◽  
William Astle ◽  
Sandra Valeina ◽  
Uwe Griebenow
Keyword(s):  
Tangential Force ◽  
Anterior Segment ◽  
Rectus Muscle ◽  
Lateral Rectus ◽  
Mean Deviation ◽  
Retrospective Case ◽  
Lateral Rectus Muscle ◽  
Abducens Paralysis ◽  
Temporal Parts ◽  
The Mean

Abstract Purpose:Since 1907, multiple transposition procedures have been established for the treatment of abducens paralysis. In this study, we try to determine where the transposed muscle should be reattached in order to increase the tangential force necessary to improve abduction.Methods:Retrospective case review of 12 consecutive patients with abducens paralysis. All patients underwent the transposition procedure between 2016 and 2019.Vertical rectus muscles are transposed to the insertion of lateral rectus muscle: The temporal parts are joined and sutured to the sclera on top of the lateral rectus muscle in the middle of the insertion. The nasal parts are sutured to the sclera following the spiral of Tillaux. The muscle junction suture is placed 8 mm from the insertion: The temporal parts of the vertical muscles bellies are joined and sutured to the lateral rectus muscle. A full tendon transposition was performed on 11 patients, a half tendon transposition procedure on one patient. The minimum follow-up was 3 months.Results:The mean preoperative deviation was ET of 37° (range: ET 24° to ET 51°). The mean preoperative abduction limitation was 5 mm from midline (range: -7 to -1mm). The postoperative mean deviation was ET of 2° PD (range: 0 to ET 5°). The postoperative mean abduction improvement was 5mm past midline (range: +2 to +6mm). There were no complications, or signs of anterior segment ischemia. Conclusions:To achieve the maximal abductive force from the transposed muscles, we suggest that the vertical muscles be reattached as close as possible to the middle of the lateral rectus insertion.

scholarly journals Surgical management of intermittent exotropia: do we have an answer for all?

2019 ◽  
Vol 4 (1) ◽  
pp. e000243 ◽  
Author(s):  
Pratik Chougule ◽  
Ramesh Kekunnaya
Keyword(s):  
Surgical Outcomes ◽  
Surgical Techniques ◽  
Rectus Muscle ◽  
Lateral Rectus ◽  
Intermittent Exotropia ◽  
Comprehensive Overview ◽  
Convergence Insufficiency ◽  
Lateral Rectus Muscle ◽  
Recurrent Exotropia ◽  
Prospective Trials

Intermittent exotropia (X(T)) is one of the most common form of strabismus with surgery being the mainstay of treatment. The main goal of surgery is to preserve binocular vision and stereopsis and to prevent its further loss. The decision to operate is mainly based on four aspects: increasing angle of exodeviation, deteriorating control of X(T), decrease in stereopsis for near or distance and quality of life. Bilateral lateral rectus muscle recession and unilateral lateral rectus recession with medial rectus resection, are the two most common surgical procedures performed and have been studied extensively in basic, divergence excess and convergence insufficiency types of X(T). However, there is no consensus over the relative efficacy of the two procedures in terms of postoperative alignment, residual or recurrent exotropia and consecutive esotropia with widely variable results, which can be attributed to poor understanding of the natural course of the disease. Multiple demographic, clinical and anatomic features that may influence the surgical outcomes have been studied to explain this variability. Moreover, most of the evidence regarding surgical outcomes of X(T) is from retrospective studies and the ongoing randomised prospective trials can shed light on long-term efficacy of these procedures. The goal of this review is to give a comprehensive overview of the outcomes of various surgical techniques in the management of different types of X(T), the preoperative and postoperative factors that may affect the surgical outcomes and to discuss the dilemmas faced by the treating surgeons including the effective management of overcorrection and undercorrection.

scholarly journals Surgical Outcomes of Unilateral Lateral Rectus Recession Versus Recess-resect in Children With Small-to-medium Angle Convergence Insufficiency-type Intermittent Exotropia

2021 ◽  
Author(s):  
Yoon Kyung Jang ◽  
Seok Hyun Bae ◽  
Dong Gyu Choi
Keyword(s):  
Surgical Outcomes ◽  
Medical Records ◽  
Lateral Rectus ◽  
Intermittent Exotropia ◽  
Surgical Success ◽  
Convergence Insufficiency ◽  
Significant Difference ◽  
Distance Difference ◽  
The Mean

Abstract To determine the efficacy of unilateral lateral rectus recession (ULR) for convergence insufficiency-type intermittent exotropia (CI-type IXT), we compared surgical outcomes following ULR and recess‒resect (RR) procedures for CI-type IXT. In this retrospective study, medical records of 57 children who underwent ULR (n = 30) or RR (n = 27) for CI-type IXT of less than 25 PD at distance with a postoperative follow-up of 6 months or more were reviewed. Surgical success was defined as an alignment between 10 PD exodeviation and 5 PD esodeviation at distance and near fixation. The postoperative exodeviation showed no significant difference between the two groups at the last follow-up. A significant reduction in the mean near-distance difference was achieved postoperatively in both groups: from 5.4 PD preoperatively to 2.5 at last follow-up after ULR, and from 8.2 to 2.4 after RR (both p = 0.001). However, this difference between ULR and RR was not statistically significant (p > 0.05). The success rate at the last follow-up was 63.3% for ULR and 70.4% for RR (p = 0.574). ULR was found to be an effective treatment for CI-type IXT, with similar surgical outcomes to RR.

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