Symmetric versus Asymmetric Surgery for Simulated Divergence Excess Intermittent Exotropia  

Oleh:

Solaiman, Kamal A.M.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: SGH Medical Journal vol. 1 no. 2 (Jul. 2006), page 124.
Topik: intermittent exotropia; simulated divergence excess; esotropia; exophoria; orthoporia.

Ketersediaan

Perpustakaan FK Nomor Panggil: S09.K Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

To evaluate and compare the effectiveness of bilateral lateral rectus (symmetric) surgery and the unilateral recess / resect (asymmetric) surgery in the management of simulated divergence excess (SDE) type of intermittent exotropia. A prospective study was designed which included 28 patients with SDE intermittent exotropia who were randomized into 2 groups according to the surgical procedure used for treatment. The symmetric surgery (SS) group included 14 patients treated by bilateral lateral rectus (LR) recession, and the asymmetric surgery (AS) group also included 14 patients treated by recess / resect surgery in the nondominant eye. Patients were examined before and after surgery for: vision with and without correction, cycloplegic refraction, cover tests, motility and binocular vision. The angle of deviation was measured for both far and near, before and at least 1 hour after monocular occlusion. Results were recorded 1 week and 6 months after surgery. One week after surgery, the mean angle of near deviation decreased from 23.57 ± 4.57 D to 0.21 ± 2.15 D in the SS group and from 26.07 ± 4.87 D to 0.57 ± 1.99 D in the AS group, while the mean angle of far deviation decreased from 36.79 ± 5.41 D to 0.79 ± 2.15 D in the SS group, and from 36.79 ± 5.75 D to 0.86 ± 2.68 D in the AS group. No statistically significant difference was found between both groups. Six months after surgery, the mean angle of near deviation changed to 1.29 ± 2.99 D in the SS group (p = .033) and to 0.57 ± 2.65 D in the AS group (p = 1.00), while the mean angle of far deviation changed to 1.43 ± 3.08 D in the SS group (p = .120) and to 1.29 ± 2.99 D in the AS group (p = .640). Successful surgical outcome occurred in 11 patients (78.6%) in the SS group and in 10 patients (71.4%) in the AS group (p > .05). The grade of binocular vision improved in 6/9 patients (66.7%) in the SS group and in 5/8 patients (62.5%) in the AS group (p > .05). No statistically significant difference was found between the success rates in both groups and the SDE type of intermittent exotropia can be treated effectively by both symmetric and asymmetric techniques.

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