title: Comparison of Long-term Surgical Outcomes Between Unilateral Recession and Unilateral Recession-Resection in Small-Angle Exotropia.
abstract: OBJECTIVE
  To compare the surgical outcomes of unilateral lateral rectus recession-medial rectus resection (RR) and unilateral lateral rectus recession (ULR) for intermittent exotropia of ≤20 prism diopters (PD).
  
  
  METHODS
  Retrospective, nonrandomized clinical study.
  
  
  METHODS
  A total of 130 children with intermittent exotropia of ≤20 PD who underwent unilateral RR or ULR of 10 mm were included. Patients were observed for at least 2 years. Success rates, cumulative probabilities of success, and factors related to recurrence and overcorrection were evaluated.
  
  
  RESULTS
  The mean follow-up duration after surgery was 3.1 ± 1.0 years in the RR group and 3.6 ± 1.6 years in the ULR group. In the RR group, 38 of 61 patients (62%) had ocular alignment within 10 PD of exophoria/tropia and 5 PD of esophoria/tropia; 18 patients (30%) had recurrence, and 5 (8%) had overcorrection. In the ULR group, 26 of 69 patients (38%) had successful alignment, 41 patients (59%) had recurrence, and 2 patients (3%) were overcorrected. At 6 months after surgery, the success rate was significantly higher in the ULR group (RR 61%; ULR 78%, P = .039), but it became comparable after 2 years (RR 60%; ULR 52%, P = .370). At the final examination after a mean duration of 3 years, the recurrence rates were lower in the RR group (30% vs 59%, P = .001), and the overcorrection rates were comparable (8% vs 3%, P = .252).
  
  
  CONCLUSIONS
  Unilateral RR resulted in more successful alignment and lower recurrence compared to ULR for the treatment of small-angle intermittent exotropia of ≤20 PD.
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
authors.forename: Hyuna
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
authors.forename: Hee Kyung
authors.initials: HK
authors.lastname: Yang
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea. Electronic address: hjm@snu.ac.kr.
authors.forename: Jeong-Min
authors.initials: JM
authors.lastname: Hwang
mesh_terms: D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D005099:Exotropia / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009801:Oculomotor Muscles / Q000503:physiopathology / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D015348:Vision, Binocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology