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Comparative study of Y-split recession versus bilateral medial rectus recession for surgical management of infantile esotropia.

Badawi N, Hegazy K - Clin Ophthalmol (2014)

Bottom Line: Group A consumed 57% less operative time than Group B.By the end of six months of follow up; 13% of the BMR technique patients vs 27% of the Y-splitting technique patients showed negative change of PD but without reoperation.Our results suggest that, although the Y-splitting technique is more difficult and time consuming, both procedures are effective and have shown comparable results for the correction of horizontal deviation ≤70 PD.

View Article: PubMed Central - PubMed

Affiliation: Ophthalmology Department, Faculty of Medicine, Menoufiya University, Shebin El-Kom, Menoufiya, Egypt.

ABSTRACT

Aim: This prospective study compares the results of bilateral medial rectus recession versus (vs) Y-split recession of medial recti techniques for surgical management of essential infantile esotropia.

Patients and methods: Thirty patients were included in this study and had preoperative infantile esotropia with large angles (ie, >30 prism diopters [PD]). Patients were divided into Group A, which underwent bilateral medial rectus (BMR) recession and Group B, which underwent bilateral Y-split recession of medial recti muscles. All patients were subjected to complete ophthalmologic examination and met the criteria for inclusion in this study. The degrees of BMR recessions performed ranged from 6.0-7.5 mm. All operations were performed under general anesthesia. Follow-up visits were conducted at 1 and 2 weeks, and 1, 3, and 6 months postoperatively. Rates of reoperation for residual esotropia and consecutive exotropia were determined.

Results: The patients' preoperative angles of deviation ranged from 30-80 PD. Group A consumed 57% less operative time than Group B. Immediately postoperatively, the Y-splitting technique showed satisfactory results (ie, orthotropic or residual angles ≤15 PD) in 73% of patients vs 67% only for the BMR recession patients. By the end of six months of follow up; 13% of the BMR technique patients vs 27% of the Y-splitting technique patients showed negative change of PD but without reoperation.

Conclusion: Our results suggest that, although the Y-splitting technique is more difficult and time consuming, both procedures are effective and have shown comparable results for the correction of horizontal deviation ≤70 PD.

No MeSH data available.


Related in: MedlinePlus

Immediate postoperative results.Abbreviations: PD, prism diopters; XT, exotropia; BMR, bilateral medial rectus; vs, versus.
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f4-opth-8-1039: Immediate postoperative results.Abbreviations: PD, prism diopters; XT, exotropia; BMR, bilateral medial rectus; vs, versus.

Mentions: Immediately postoperatively, the BMR recession technique showed satisfactory results (ie, orthotropic or residual angle ≤10 PD) in 67% of patients versus (vs) 73% of patients in the Y-split group. The immediately postoperative unsatisfactory results were in the form of residual angle of deviation >10 PD that was encountered in 27% of BMR patients vs 13% of Y-split patients. The other unsatisfactory postoperative result was consecutive XT that occurred in 6% of BMR patients vs 13% of Y-split patients (Figure 4). Cases with unsatisfactory results in the form of residual angle >15 PD were managed surgically in the form of re-recession (in the BMR group), or reuniting split halves of the MR and recession (for the Y-split group), while the cases of XT were managed by advancement in the BMR group and bilateral rectus recession in the Y-split group.


Comparative study of Y-split recession versus bilateral medial rectus recession for surgical management of infantile esotropia.

Badawi N, Hegazy K - Clin Ophthalmol (2014)

Immediate postoperative results.Abbreviations: PD, prism diopters; XT, exotropia; BMR, bilateral medial rectus; vs, versus.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4043800&req=5

f4-opth-8-1039: Immediate postoperative results.Abbreviations: PD, prism diopters; XT, exotropia; BMR, bilateral medial rectus; vs, versus.
Mentions: Immediately postoperatively, the BMR recession technique showed satisfactory results (ie, orthotropic or residual angle ≤10 PD) in 67% of patients versus (vs) 73% of patients in the Y-split group. The immediately postoperative unsatisfactory results were in the form of residual angle of deviation >10 PD that was encountered in 27% of BMR patients vs 13% of Y-split patients. The other unsatisfactory postoperative result was consecutive XT that occurred in 6% of BMR patients vs 13% of Y-split patients (Figure 4). Cases with unsatisfactory results in the form of residual angle >15 PD were managed surgically in the form of re-recession (in the BMR group), or reuniting split halves of the MR and recession (for the Y-split group), while the cases of XT were managed by advancement in the BMR group and bilateral rectus recession in the Y-split group.

Bottom Line: Group A consumed 57% less operative time than Group B.By the end of six months of follow up; 13% of the BMR technique patients vs 27% of the Y-splitting technique patients showed negative change of PD but without reoperation.Our results suggest that, although the Y-splitting technique is more difficult and time consuming, both procedures are effective and have shown comparable results for the correction of horizontal deviation ≤70 PD.

View Article: PubMed Central - PubMed

Affiliation: Ophthalmology Department, Faculty of Medicine, Menoufiya University, Shebin El-Kom, Menoufiya, Egypt.

ABSTRACT

Aim: This prospective study compares the results of bilateral medial rectus recession versus (vs) Y-split recession of medial recti techniques for surgical management of essential infantile esotropia.

Patients and methods: Thirty patients were included in this study and had preoperative infantile esotropia with large angles (ie, >30 prism diopters [PD]). Patients were divided into Group A, which underwent bilateral medial rectus (BMR) recession and Group B, which underwent bilateral Y-split recession of medial recti muscles. All patients were subjected to complete ophthalmologic examination and met the criteria for inclusion in this study. The degrees of BMR recessions performed ranged from 6.0-7.5 mm. All operations were performed under general anesthesia. Follow-up visits were conducted at 1 and 2 weeks, and 1, 3, and 6 months postoperatively. Rates of reoperation for residual esotropia and consecutive exotropia were determined.

Results: The patients' preoperative angles of deviation ranged from 30-80 PD. Group A consumed 57% less operative time than Group B. Immediately postoperatively, the Y-splitting technique showed satisfactory results (ie, orthotropic or residual angles ≤15 PD) in 73% of patients vs 67% only for the BMR recession patients. By the end of six months of follow up; 13% of the BMR technique patients vs 27% of the Y-splitting technique patients showed negative change of PD but without reoperation.

Conclusion: Our results suggest that, although the Y-splitting technique is more difficult and time consuming, both procedures are effective and have shown comparable results for the correction of horizontal deviation ≤70 PD.

No MeSH data available.


Related in: MedlinePlus