Korean J Ophthalmol.  2011 Apr;25(2):139-141. 10.3341/kjo.2011.25.2.139.

Supermaximal Recession and Resection in Large-Angle Sensory Exotropia

• Chang JH
• Kim HD
• Lee JB
• Han SH

• KMID: 1111878
• DOI: http://doi.org/10.3341/kjo.2011.25.2.139

Abstract

In cases of extropia with an exodeviation angle over 50 prism diopter (PD), a 3- or 4-muscle surgery is a rational option. But, in patients with sensory exotropia, there is usually a strong preference for a monocular procedure to avoid surgery on the single seeing eye. Thus, we confined surgery to visually poor eyes, and performed a medial rectus muscle resection with a mean of 10.3 mm (range, 9-11 mm) and a lateral rectus muscle recession with a mean of 12.8 mm (range, 10-14 mm) in 4 adult sensory exotropia patients who had a mean deviation of 82.3 PD (range, 75-90 PD). The mean postoperative angle of exodeviation was 2.0 PD (range, ortho-8 PD). The limitation on abduction was not disfiguring. Other expected disfigurements, such as narrowing of the palpebral fissure or enophthalmos, were not conspicuous. The mean follow-up period was 4.5 months (range, 3-7 months). In large-angle sensory exotropia, instead of additive surgery on the seeing eye, supermaximal medial rectus resection and lateral rectus recession only on the visually poor eye is a clinically feasible surgical option.

Keyword

Large sensory exotropia; Recession and resection; Supermaximal

MeSH Terms

Adult
Exotropia/physiopathology/*surgery
*Eye Movements
Female
Follow-Up Studies
Humans
Male
Middle Aged
Oculomotor Muscles/physiopathology/*surgery
Postoperative Period
Vision, Ocular

Figure

• 

  Fig. 1 Photographs of 51 year-old woman (patient 2) with 75 prism diopter left exotropia before surgery due to macular degeneration of the left eye (upper). Left medial rectus 9 mm resection and left lateral rectus 14 mm recession were performed. No postoperative deviation was detected at 5 months after surgery (lower).

• 

  Fig. 2 Photographs of 33 year-old man (patient 3) with 90 prism diopter left exotropia before surgery due to optic atrophy of the left eye (upper). Left medial rectus resection of 11 mm and left lateral rectus recession of 14 mm were performed. Postoperative deviation was nearly straight at 7 months after surgery (lower).

• 

  Fig. 3 Photographs of 29 year-old man (patient 4) with 80 prism diopter right exotropia before surgery due to traumatic cataract on right eye (upper). Right medial rectus resection of 11 mm and right lateral rectus recession of 10 mm were performed. Postoperative deviation was 8 prism diopter right exotropia at 3 months after surgery (lower).

Reference

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