期刊名称:Journal of the Korean Ophthalmological Society
印刷版ISSN:0378-6471
出版年度:2019
卷号:60
期号:2
页码:169-175
DOI:10.3341/jkos.2019.60.2.169
出版社:The Korean Ophthalmological Society
摘要: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.