title: Lateral rectus recession with/without transposition in V-pattern exotropia without inferior oblique overaction.
abstract: OBJECTIVE
  To compare bilateral lateral rectus (BLR) recession with BLR recession combined with half-tendon upward transposition in the management of patients with V-pattern exotropia (XT; 15-20 prism diopters [PD] greater XT in upgaze than downgaze) with no or minimal inferior oblique overaction.
  
  
  METHODS
  Retrospective, observational, cohort study.
  
  
  METHODS
  Twenty-nine patients had BLR recession (Group A). Twenty-one patients had BLR recession combined with half-tendon upward transposition (Group B).
  
  
  METHODS
  A retrospective study was performed on patients with V-pattern XT with no or minimal inferior oblique overaction. Ductions, versions, pattern strabismus, stereoacuity, and degree of fundus torsion were analyzed in all patients before and after surgery. Patients were included in the study only if they achieved a minimum follow-up of 6 months.
  
  
  RESULTS
  Normalization of V pattern (<5Δ) was achieved in 14% in Group A and 64% in Group B (p < 0.001). Mean reduction in V pattern after surgery was 7Δ ± 6Δ in Group A and 13Δ ± 4Δ in Group B (p < 0.001). No change in fundus intorsion occurred in Group A, whereas fundus extorsion occurred in 8 patients (44%) in Group B. Orthophoria within 8Δ in the primary position was achieved in 79% in Group A and 82% in Group B (p = 1.00). There was no statistically significant difference in the postoperative stereoacuity in both groups (p = 0.67).
  
  
  CONCLUSIONS
  BLR with half-tendon upward transposition is much more effective than BLR recession alone in correcting V pattern.
authors: Cairo University Faculty of Medicine, Cairo, Egypt. Electronic address: ahmedawadein@yahoo.com.
authors: Ahmed
authors: A
authors: Awadein
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005099:Exotropia / Q000503:physiopathology / Q000601:surgery*; D005133:Eye Movements / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D009801:Oculomotor Muscles / Q000503:physiopathology / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D012189:Retrospective Studies; D013709:Tendon Transfer; D015348:Vision, Binocular / Q000502:physiology; D055815:Young Adult