PURPOSE: To compare the surgical outcomes of bilateral lateral rectus recession and unilateral recess-resect (RR) procedure on the nondominant eye for the patients of exotropia with a dominant fixating eye. DESIGN: Pr...PURPOSE: To compare the surgical outcomes of bilateral lateral rectus recession and unilateral recess-resect (RR) procedure on the nondominant eye for the patients of exotropia with a dominant fixating eye. DESIGN: Prospective randomized comparative clinical trial. METHODS: One hundred twenty four patients of exotropia with an invariably fixating eye were enrolled to this study. Patients were assigned randomly to two groups, those who underwent bilateral lateral rectus (BLR)-recessions (BLR group) or unilateral RR procedures on the nondominant eye (RR group); surgical outcomes were compared. An outcome was considered satisfactory if there was between 10 prism diopters of exophoria/tropia and 10 prism diopters of esophoria/tropia at 6 months after surgery. RESULTS: In the BLR group, 28 of the 58 patients (48.3% ) had a satisfactory outcome, and 30 patients (51.7% ) had recurrence. There was no case of overcorrection in the BLR group. In the RR group, 55 of the 66 patients (83.3% ) had a satisfactory outcome; 6 patients (9.1% ) had recurrence, and 5 patients (7.6% ) were overcorrected (P < .001, Fisher’s exact test). All overcorrected patients in the RR group had poor stereoacuity and constant exotropia before the operation. The cumulative probability of surgical success was significantly higher in the RR group than in the BLR group (P=.012, log rank test). CONCLUSIONS: In the patients with exotropia with a dominant eye, the unilateral RR procedure resulted in a better outcome than BLR recession surgery. But, the overcorrection rate was significantly higher in the unilateral RR procedure group, especially in those patients with a poor preoperative stereopsis status and constant exotropia.展开更多
PURPOSE: To determine whether complete detachment of the fascia of the capsulopalpebral head during large inferior rectus recession can help to prevent induced lower lid retraction in Graves ophthalmopathy. DESIGN:Ret...PURPOSE: To determine whether complete detachment of the fascia of the capsulopalpebral head during large inferior rectus recession can help to prevent induced lower lid retraction in Graves ophthalmopathy. DESIGN:Retrospective consecutive case series. METHODS: Data from patients (39 eyes) with Graves ophthalmopathy undergoing inferior rectus recession were collected retrospectively. Inferior rectus recession was performed by limbus-based incision with adjustable suture. Simultaneous detachment of the fascia of the capsulopalpebral head was achieved by sharp dissection and severing of the fascia. Inferior rectus recession with simultaneous detachment of the fascia of the capsulopalpebral head was performed in 27 eyes and without detachment in 12 eyes. Margin reflex distance (MRD2) was documented preoperatively and 3 months postoperatively. RESULTS: Of the 39 eyes included in this study, four eyes with preexisting lower lid retraction in the detachment group improved after surgery. Eighteen eyes in the detachment group exhibited the same MRD2 values, and only five eyes showed increased MRD2 values. In contrast, all but one of the 12 eyes in the nondetachment group showed increased MRD2 values. The average change in the MRD2 value 3 months after surgery was 0.04 ±0.59 mm in the detachment group and 1.58 ±0.73 mm in the nondetachment group. There was a statistically significant difference between the two groups (P < .01). CONCLUSIONS: Simultaneous detachment of the fascia of the capsulopalpebral head during inferior rectus recession can minimize the possibility of lower lid retraction.展开更多
文摘PURPOSE: To compare the surgical outcomes of bilateral lateral rectus recession and unilateral recess-resect (RR) procedure on the nondominant eye for the patients of exotropia with a dominant fixating eye. DESIGN: Prospective randomized comparative clinical trial. METHODS: One hundred twenty four patients of exotropia with an invariably fixating eye were enrolled to this study. Patients were assigned randomly to two groups, those who underwent bilateral lateral rectus (BLR)-recessions (BLR group) or unilateral RR procedures on the nondominant eye (RR group); surgical outcomes were compared. An outcome was considered satisfactory if there was between 10 prism diopters of exophoria/tropia and 10 prism diopters of esophoria/tropia at 6 months after surgery. RESULTS: In the BLR group, 28 of the 58 patients (48.3% ) had a satisfactory outcome, and 30 patients (51.7% ) had recurrence. There was no case of overcorrection in the BLR group. In the RR group, 55 of the 66 patients (83.3% ) had a satisfactory outcome; 6 patients (9.1% ) had recurrence, and 5 patients (7.6% ) were overcorrected (P < .001, Fisher’s exact test). All overcorrected patients in the RR group had poor stereoacuity and constant exotropia before the operation. The cumulative probability of surgical success was significantly higher in the RR group than in the BLR group (P=.012, log rank test). CONCLUSIONS: In the patients with exotropia with a dominant eye, the unilateral RR procedure resulted in a better outcome than BLR recession surgery. But, the overcorrection rate was significantly higher in the unilateral RR procedure group, especially in those patients with a poor preoperative stereopsis status and constant exotropia.
文摘PURPOSE: To determine whether complete detachment of the fascia of the capsulopalpebral head during large inferior rectus recession can help to prevent induced lower lid retraction in Graves ophthalmopathy. DESIGN:Retrospective consecutive case series. METHODS: Data from patients (39 eyes) with Graves ophthalmopathy undergoing inferior rectus recession were collected retrospectively. Inferior rectus recession was performed by limbus-based incision with adjustable suture. Simultaneous detachment of the fascia of the capsulopalpebral head was achieved by sharp dissection and severing of the fascia. Inferior rectus recession with simultaneous detachment of the fascia of the capsulopalpebral head was performed in 27 eyes and without detachment in 12 eyes. Margin reflex distance (MRD2) was documented preoperatively and 3 months postoperatively. RESULTS: Of the 39 eyes included in this study, four eyes with preexisting lower lid retraction in the detachment group improved after surgery. Eighteen eyes in the detachment group exhibited the same MRD2 values, and only five eyes showed increased MRD2 values. In contrast, all but one of the 12 eyes in the nondetachment group showed increased MRD2 values. The average change in the MRD2 value 3 months after surgery was 0.04 ±0.59 mm in the detachment group and 1.58 ±0.73 mm in the nondetachment group. There was a statistically significant difference between the two groups (P < .01). CONCLUSIONS: Simultaneous detachment of the fascia of the capsulopalpebral head during inferior rectus recession can minimize the possibility of lower lid retraction.
