title: Comparative study of plication-recession versus resection-recession in unilateral surgery for intermittent exotropia.
abstract: OBJECTIVE
  Plication is a muscle-strengthening procedure in which a muscle is not dissected from its point of insertion. The purpose of this study was to compare the results of plication-recession (PR) with those of resection-recession (RR) in adult patients with intermittent exotropia (XT).
  
  
  METHODS
  Patients with XT who underwent either PR or RR with a minimum postoperative follow-up of 12 months were retrospectively reviewed. Postoperative mean distance deviation and surgical outcomes were compared at 1 week and at 1, 3, 6, and 12 months, and at the final follow-up. A successful outcome was defined as esophoria or esotropia ≤5 PD (prism diopters) to exophoria or exotropia ≤10 PD.
  
  
  RESULTS
  Forty-five patients underwent PR and 43 underwent RR. The mean preoperative distance deviation was 40.1 ± 12.9 PD in the PR group and 40.0 ± 14.9 PD in the RR group (P = 0.96). Mean follow-up was 21.0 ± 7.6 months for PR and 24.0 ± 8.6 months for RR (P = 0.08). The mean postoperative distance deviation at 12 months was 8.3 ± 7.4 PD for PR and 9.9 ± 9.6 PD for RR (P = 0.38). PR had a significantly better outcome than RR at 1 week (PR 89%; RR 72%; P = 0.04), but there was no difference between PR and RR at 12 months (PR 67%; RR 60%; P = 0.50).
  
  
  CONCLUSIONS
  PR and RR achieved comparable distance deviation and success rates at 12 months. PR had a better short-term success rate, and might prevent postoperative diplopia caused by overcorrection.
authors.affiliation: Kimura Eye and Internal Medicine Hospital, 3-15 Takaramachi, Kure, Hiroshima, 737-0029, Japan. ky.kimuraeye@gmail.com.
authors.forename: Yugo
authors.identifier: http://orcid.org/0000-0002-6620-2540
authors.initials: Y
authors.lastname: Kimura
authors.affiliation: Kimura Eye and Internal Medicine Hospital, 3-15 Takaramachi, Kure, Hiroshima, 737-0029, Japan.
authors.forename: Tohru
authors.initials: T
authors.lastname: Kimura
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005099:Exotropia / Q000503:physiopathology / Q000601:surgery*; D005133:Eye Movements / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000503:physiopathology / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D015348:Vision, Binocular / Q000502:physiology*; D014792:Visual Acuity; D055815:Young Adult
keywords: Exotropia; Plication; Recession; Resection; Surgery