J Korean Ophthalmol Soc > Volume 59(6); 2018 > Article
Journal of the Korean Ophthalmological Society 2018;59(6):577-581.
DOI: https://doi.org/10.3341/jkos.2018.59.6.577    Published online June 15, 2018.
The Effect of Bilateral Medial Rectus Resection for Recurrent Intermittent Exotropia.
Sae Rom Chung, Tae Eun Lee, In Cheon You, Nam Chun Cho, Min Ahn
1Department of Ophthalmology, Chonbuk National University Medical School, Jeonju, Korea. ahnmin@jbnu.ac.kr
2Research Institute of Clinical Medicine, Chonbuk National University, Jeonju, Korea.
3Biomedical Research Institute, Chonbuk National University Hospital, Jeonju, Korea.
양안 외직근후전술 후 재발한 간헐외사시에서 양안 내직근절제술의 효과
정새롬1⋅이태은1,2,3⋅유인천1,2,3⋅조남천1,2,3⋅안 민1,2,3
전북대학교 의학전문대학원 안과학교실1, 전북대학교 임상의학연구소2, 전북대학교병원 의생명연구원3
Correspondence:  Min Ahn,
Email: ahnmin@jbnu.ac.kr
Received: 28 December 2017   • Revised: 2 April 2018   • Accepted: 26 May 2018
Abstract
PURPOSE
The purpose of this study was to investigate the effect of bilateral medial rectus muscle resection on the treatment of recurrent intermittent exotropia. METHODS: A retrospective chart analysis was conducted for 25 patients who underwent bilateral medial rectus resection for recurrent exotropia over 20 prism diopters (PD) between January 2009 and August 2015. The medial rectus was resected from 4.0 to 6.5 mm by 0.5 mm according to the deviation angle. The postoperative angle of deviation was checked at 1 day, 1 week, 3 months, 6 months, and 1 year postoperatively to investigate the amount of corrected deviation per resected muscle. RESULTS: The average preoperative deviation angle was 27.20 ± 5.02 PD exodeviation and the mean resection was 5.10 ± 0.79 mm of the medial rectus. The postoperative angle deviation was 10.68 ± 5.50 PD esodeviation at 1 day. The incidence of esodeviation tended to decrease over time. At 1 year, the postoperative angle deviation was 1.16 ± 7.54 PD esodeviation. The overcorrection rate was 84% at 1 day postoperatively but decreased to 24% at 1 year with a success rate of 68%. The corrected deviation angle per millimeter was 7.53 ± 1.22, 7.75 ± 2.16, 6.27 ± 1.74, 5.50 ± 1.54, and 5.56 ± 1.58 PD/mm at 1 day, 1 week, 3 months, 6 months, and 1 year after surgery, respectively. The dose effect per millimeter decreased over time. The corrected deviated angle per millimeter remained constant regardless of the amount of medial rectus muscle resection at 1 year postoperatively(p=0.939). CONCLUSIONS: Bilateral medial rectus resection for recurrent exotropia over 20 PD tended to overcorrect at first; however, after 1 year, the mean angle of deviation was 1.16 ± 7.54 PD esodeviation. Bilateral medial rectus resection is an effective surgical method for the treatment of recurrent exotropia over 20 PD.
Key Words: Bilateral lateral rectus recession;Bilateral medial rectus resection;Recurrent exotropia


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