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828
70th AIOC Proceedings, Cochin 2012
disorder includes limiting the risk of surgery to one eye, lower incidence of
overcorrection, little change in their alignment from the early post-operative
period and shorter duration of anesthesia.
The purpose of this study was to compare the surgical and functional outcome
of unilateral and bilateral rectus recession in the treatment of divergence
excess type of small angle exotropia.
MATERIALS AND METHODS
100 patients with intermittent exotropia less than 25 PD were enrolled for this
study. Criteria for enrollment were: Divergence excess type of intermittent
exotropia (a) with devialtion less than 25 PD (b) best corrected VA>= 6/9. (c)
no A or V Pattern (d) No history of previous strabismus surgery. (e) full preoperative
duction and version.
The patients were randomly divided into two groups of 50 each. Group A
underwent unilateral rectus recession and Group B underwent bilateral
lateral rectus recession. Measurment were taken at 6m for distance and 30 cm
for near deviation after patching one eye for 24 hrs in primary position and
in 30 degree side gaze for lateral incomittance. Side gaze measurement was
made by rotating the face an estimated 30 degree and having the patient to
look forward. Biocular status of the patient was assessed by worth 4 dot test
and synaptophore. Corneal topography was done both preoperatively and
postoperatively to compare any change in refractive states. All surgeries were
performed by conventional hangback technique by one surgeon. The decision
on the amount of lateral rectus recession was taken on an individual basis
keeping in mind the preoperative factors influencing the outcome of surgery,
in each case following the guidelines described by strabismologist.
Table 1: Guidelines for Lateral Rectus Recession Surgery
PD Group A Group B
15 7 mm 4 mm
20 8 mm 5 mm
25 9 mm 6 mm
A satisfactory result was considered when the alignment is within 8 PD of
orthophoria. An incommitant postoperative result was considered present,
when alignment changed for more than 20% greater from primary to lateral
side.
RESULTS
The mean age of the patients at the time of surgery was 9.60+-4.79 in Group
A and 9.93+-4.71 yrs in Group B. The preoperative mean angle in Group A for