Effect of Axial Length (Myopia) on Horizontal Recti Recession in Children with Horizontal Strabismus

PURPOSE: To assess the influence of axial length for surgical outcome of horizontal recti recession in children with horizontal strabismus. METHODS: A retrospective, non-comparative case series. 100 patients, 96 males and 44 females with unilateral or bilateral high myopia and strabismus surgery was performed. All patients had horizontal recti recession and no combined vertical strabismus. There was no history of any ocular trauma or surgery and no history of any other systemic diseases that affect ocular motility. After horizontal recti recession, the patients were followed-up for more than one year. Data was analyzed using SPSS Software for Windows, version 12.0.1. RESULTS: In 100 children, the mean axial length was 23.21 +/- 1.38 mm (range, 19.63-26.50 mm) and the mean age was 7.43 +/- 2.86 years (range, 1-14 years). Lateral rectus recession was in 89 cases, and medial rectus recession was done in 11 cases. After operation, 86 cases were fully corrected, 11 cases were under corrected and 3 cases were over corrected. Binary logistic regression analysis was performed revealing that, preoperative angle of deviation (p-value 0.062) and axial length (p-value 0.05) were highly correlated with surgical outcome. CONCLUSIONS: Age, preoperative angle of deviation, and axial length may influence the surgical outcome of horizontal recti recession in children. In eyes with long axial length, the surgical outcome of horizontal recti recession appears to be poorer than that in eyes with short axial lengths. Adjusting the recession amounts when performing horizontal recti recessions in long axial length eyes may provide better results.

Asymmetric Bilateral Lateral Recti Recession in Intermittent Exotropia

It is reported that the recurrence rate in intermittent exotropia is 20-50%. In this study, we evaluated whether the recurrence is reduced with asymmetric recession of bilateral lateral recti(LROU) in intermittent exotropia.Twenty-nine patients underwent the asymmetric LROU recession for intermittent exotropia with follow-up of 6-54 months. The amount of recession of lateral rectus muscle in deviating eye was 2mm more than in the fixating eye. Immediate postoperative overcorrection, the rate of orthophotia, and the occurrence of consecutive esotropia(ET) were analysed.The mean amount of immediate postoperative esodeviation was 16.5+/-7.4PD(0-34PD); four patients showed 0-4PD, 18 patients 11-20PD, and 7 patients showed considerable amount of ET as high as 21-30PD. Consecutive EToccurred in 6.8% of patients despite large amounts of postoeprative ET. The outcome of orthophoria was favorable, in 93.1% of patients in follow up of 6 months, 85.1% in 12 months and 78.5% in 24 months.This study suggests that asymmetric LROU recession is an effective procedure for the correction of intermittent exotropia.