RESUMEN
@#AIM:To compare the curative effect between monocular lateral rectus recession(BLR)and Binocular recession resection(R & R)for basic intermittent exotropia.<p>METHODS:A literature review using the MEDLINE, EMBASE, The Cochrane Library, Web of Science, Clinical Trial, CBM, Wanfang Databases and paper collections of conferences was performed. Randomized controlled trials comparing the effects of BLR and R & R for basic intermittent exotropia with a duration of follow-up at least half a year were eligible for inclusion. The methodologic quality of included studies was evaluated independently by 2 authors. Statistical analysis was performed by using the STATA 14 software(StataCorp Texas USA).<p>RESULTS:Five prospective random controlled clinical trials involving 529 patients were included. Compared with R & R procedure,the BLR procedure group showed lower successful rate(<i>RR</i>:0.85; 95% <i>CI</i>:0.72-0.99; <i>P</i>=0.043)and postoperative undercorrection(<i>RR</i>:3.975; 95% <i>CI</i>:2.097-7.537; <i>P</i><0.01). The <i>P</i> value of long-term postoperative corrected rate in Meta analysis was decreased near to 0.05 when the included references increased. There was no significant difference in overcorrection rate between the BLR and R & R procedures(<i>RR</i>:0.336; 95% <i>CI</i>:0.049-2.294; <i>P</i>=0.266).<p>CONCLUSION:Current evidences suggested that BLR procedure is related to lower successful and higher undercorrection rates for basic intermittent exotropia compared to conventional R & R procedure.
RESUMEN
To treat intermittent exotropia, bilateral recession or monocular recession-resection can be chosen. Thirty one cases of intermittent exotropia with preoperative exoangle 25 delta were treated with 8mm bilateral recession (15 cases) and 5.5mm recession of lateral rectus muscle combined with 5mm resection of medial rectus muscle (16 cases). The final surgical results were compared between the 2 groups. The surgical results were as follows: in bilateral recession group, 33.3% was satisfactory, 60.0% undercorrected, and 6.7% overcorrected with 13.7 months of follow-up in average, in monocular recession-resection group, 50.0% was satisfactory, 18.8% undercorrected, and 31.3% overcorrected with 13.0 months of follow-up in average. Monocular recession-resection procedure had better satisfactory result than that of bilateral recession procedure. The author agrees the opmion that recession-resection produces a more permanent result than recession alone because the resection of the medial rectus muscle locks the eye in better alignment, preserving the benefit of the recessed lateral rectus muscle.