Inferior Oblique Muscle, Intermittent Exotropia, Overaction, Surgical Correction, V Pattern
Conditions
Brief summary
Evaluation of the results of surgical correction of V pattern intermittent exotropia without inferior oblique muscle overaction by either performing bilateral lateral rectus recession (BLR) alone or performing bilateral lateral rectus recession asssosiated with upward transposition of lateral rectus muscle insertion
Detailed description
Intermittent exotropia (IXT) is the most common type of strabismus which is a disorder of binocular eye movement control in which one eye intermittently moves outwards.Intermittent exotropia may be associated with difference in the horizontal deviation from the primary position to the upward or downward gaze giving A or V pattern In V-pattern intermittent exotropia (XT), there is an increase in the horizontal deviation as the eyes move from downgaze to upgaze. Non-surgical treatment includes correction of refractive error, orthoptics, overcorrecting minus lenses and prismotherapy. Surgical options includes unilateral medial rectus muscle resection combined with a lateral rectus muscle recession or bilateral lateral rectus recession as in basic type IXT OR bilateral lateral rectus muscle recession as in divergent excess type OR bilateral medial rectus muscle resection as in convergence insufficiency.
Interventions
PROCEDUREBilateral Lateral Rectus Recession with Upward Transposition
This procedure involved bilateral lateral rectus recession combined with upward transposition of the insertion to enhance ocular alignment in patients with large-angle exotropia.
PROCEDUREBilateral Lateral Rectus Recession (BLR Recession)
This procedure involved recession of both lateral rectus muscles to reduce large-angle exotropia.
Sponsors
Tanta University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
5 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Patients with V pattern intermittent exotropia (XT increasing by \>10Δ in upgaze compared with Downgaze). * No or minimal inferior oblique overaction on both sides (+1) * Minimum follow-up period of 6 months after surgical correction of strabismus
Exclusion criteria
* Structural eye pathology. * Significant neurodevelopmental delay. * ntermittent exotropia without V pattern. * Superior oblique under action. * Duane syndrome. * Less than 6 months follow up.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Angle of Ocular Deviation | 6 months postoperatively | The degree of ocular misalignment was measured using prism cover test at near and distance fixation. Successful outcome was defined as residual deviation ≤10 prism diopters. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative Complications | 6 months postoperatively | Complications such as overcorrection, undercorrection, or limitation of ocular motility were recorded. |
Countries
Egypt
Outcome results
None listed