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Subject Area

Clinical Pathology

Article Type

Original Study

Abstract

Objectives To compare the efficacy of bilateral lateral rectus recession (BLR) surgery versus BLR plus one medial rectus resection surgery in the management of exotropia (XT). Background The exact nature of this surgery remains debatable, with some surgeons preferring the BLR procedure and others the unilateral recession resection procedure. Patients and methods A total of 40 patients with XT were classified into two equal groups according to the type of surgical technique used: group 1 included 20 patients who underwent BLR surgery, and group 2 included 20 patients who underwent BLR plus one medial rectus resection surgery in the management of XT. Results The outcome of surgery after the end of the follow-up period (6 months) was recorded as follows: 14 (70%) patients and 11 (55%) patients were corrected in groups 1 and 2, respectively; one (5%) patient and eight (40%) patients were overcorrected in groups 1 and 2, respectively; and five (25%) patients and one (5%) patient were undercorrected in groups 1 and 2, respectively. There was a statistically highly significant difference between groups 1 and 2 (P < 0.001). The overall success of strabismus surgery was 70% in group 1, being lower than group 2 (80%). Conclusion The study indicates that both two-muscle and three-muscle surgeries effectively treat different degrees of XT, with a low rate of induced lateral incomitance; however, the three-muscle techniques showed more successful treatment than the two-muscle techniques.

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