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Comparison of bilateral/unilateral lateral rectus recession and unilateral recession-resection for intermittent exotropia: a Meta-analysis. | LitMetric

AI Article Synopsis

  • The study aims to compare the effectiveness of unilateral recession-resection (R&R) versus bilateral/unilateral recession (BLR/ULR) for treating intermittent exotropia.
  • A meta-analysis of nine eligible studies found that R&R performs better in the short term, while BLR provides better long-term success rates for basic type IX(T) in children.
  • The results suggest R&R is preferable for small-angle IX(T) (≤20 PD), while both R&R and ULR are effective for moderate-angle IX(T) (20 PD-25 PD).

Article Abstract

Aim: To compare the effectiveness of unilateral recession-resection (R&R) and bilateral/unilateral recession (BLR/ULR) for treatment of basic type of intermittent exotropia [IX(T)].

Methods: A comprehensive literature search was performed using PubMed, EMBASE, and the Cochrane Library, to identify randomized controlled trials and comparative studies regarding the effectiveness of R&R and BLR/ULR for IX(T). Based on which, a Meta-analysis was then performed in terms of long-term success rate, overcorrection rate, and recurrence rate.

Results: Nine studies in total satisfy the specified eligibility criteria. BLR is at disadvantage to R&R at a short-term follow-up [<2y, OR 0.56 (0.33-0.94) for success rate; OR 2.11 (1.17, 3.81) for undercorrection rate]. However, BLR achieved a higher success rate [OR 2.49 (1.61, 3.86)] and a lower undercorrection rate [OR 0.40 (0.23, 0.71)], compared to that of R&R at a long-term follow-up (>2y). There is no significant difference was found in overcorrection rate, regardless of the length of follow-up time [OR 0.85 (0.41, 1.75)]. In the treatment for small-angle IX(T), the final outcome was significantly different between the groups, demonstrating a more successful alignment [OR 0.37 (0.18, 0.74)] and a lower undercorrection [OR 3.50 (1.28, 7.26)] in the R&R group than in the ULR group. While for moderate-angle IX(T) (20 PD-25 PD), the effectiveness of R&R and ULR is quite equivalent with similar success rate [OR 1.08 (0.65, 1.79)] and undercorrection rate [OR 0.89 (0.54, 1.48)].

Conclusion: As regard to the effect of BLR and R&R, R&R shows an advantage over BLR at short term. But, BLR is more effective in the long term for the basic type IX(T) in children. R&R surgery should be a better choice for the treatment of small-angle IX(T) of ≤20 PD than ULR. However, both of ULR and R&R are recommended for moderate-angle IX(T) from 20 PD to 25 PD.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6288523PMC
http://dx.doi.org/10.18240/ijo.2018.12.18DOI Listing

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