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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

Postoperative results at 6 months’ follow-up.Abbreviation: BMR, bilateral medial rectus.
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f5-opth-8-1039: Postoperative results at 6 months’ follow-up.Abbreviation: BMR, bilateral medial rectus.

Mentions: Comparing the immediate postoperative surgical outcomes with outcomes at 6-month follow-up (Figure 5), 13% of the BMR patients showed negative changes with no reoperation vs 27% in the Y-split group. Concerning satisfaction with immediate results and postoperative changes, two patients in the Y-split group showed satisfactory results immediately after the operation, but we observed negative changes within the next 6 months. Changes were for the worse, from esotropia with a PD of 10 to esotropia with a PD of 15 in one patient, and from orthophoria to esotropia with a PD of 20 in a second patient. Statistical analysis by P-value of the final output of both surgeries showed no statistical significance in the comparison of the efficacy of one technique over the other.


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

Badawi N, Hegazy K - Clin Ophthalmol (2014)

Postoperative results at 6 months’ follow-up.Abbreviation: BMR, bilateral medial rectus.
© Copyright Policy
Related In: Results  -  Collection

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

f5-opth-8-1039: Postoperative results at 6 months’ follow-up.Abbreviation: BMR, bilateral medial rectus.
Mentions: Comparing the immediate postoperative surgical outcomes with outcomes at 6-month follow-up (Figure 5), 13% of the BMR patients showed negative changes with no reoperation vs 27% in the Y-split group. Concerning satisfaction with immediate results and postoperative changes, two patients in the Y-split group showed satisfactory results immediately after the operation, but we observed negative changes within the next 6 months. Changes were for the worse, from esotropia with a PD of 10 to esotropia with a PD of 15 in one patient, and from orthophoria to esotropia with a PD of 20 in a second patient. Statistical analysis by P-value of the final output of both surgeries showed no statistical significance in the comparison of the efficacy of one technique over the other.

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