Evaluation of unilateral lateral rectus muscle recession for correction of small-angle intermittent exotropia

Abstract

Background: Various surgical techniques have been proposed for the treatment of intermittent exotropia. Unilateral lateral rectus recession is a surgical option that has been recommended for treating minor to moderate-angle exotropia.Objective: This research aims to assess the surgical results of performing unilateral lateral rectus recession for the treatment of moderate-angle exotropia (≤ 30 PD).Patients and methods: This prospective, institutional, clinical trial was conducted at Tanta University Hospital from March 2022 to February 2023. It included 30 patients with small-angle intermittent exotropia ≤ 30 prism diopters who underwent unilateral lateral rectus muscle recession. The study aimed to evaluate the effectiveness of this surgical approach in correcting small-angle intermittent exotropia, with a follow-up period of 6 months.Results: The average age at the time of surgery was 14.033 ± 9.715 years, ranging from 6 to 37 years, with 80% (24 patients) being pediatric (below 18 years) and 20% (6 patients) adults. A significant reduction in the distant deviation angle was observed postoperatively. One week after surgery, the mean angle was -5.833 ± 9.255Δ, reducing to -4.5 ± 8.444Δ after 1 month, and further to -2.667 ± 5.040Δ at 3 months, with continued improvement at 6 months (-1.000 ± 3.051Δ). Success rate, defined as deviation of ≤ 10 PD, was achieved in 73%.Conclusion: Performing unilateral lateral rectus recession was shown to be effective in achieving a high postoperative success rate in patients with intermediate angle exotropia, according to the research.