继发性外斜视手术方式及术后眼位变化

目的研究内斜视术后继发外斜视的手术方式及术后眼位的变化。方法手术治疗43例内斜视术后继发外斜视的病人,探讨其手术方式并观察术后1周、6周、6个月和1年的眼位变化情况。结果单眼内直肌前徙7例,单眼内直肌缩短4例,单眼内直肌前徙＋单眼外直肌后徙20例,双眼外直肌后徙5例,单眼外直肌后徙3例;4例外斜视度数≥50△行3条肌肉的手术。术后1年35例眼位正位（81.3%）,其中单眼内直肌前徙或缩短11例术后8例（72.7%）正位,外直肌后徙8例（5例为双眼,3例为单眼）术后6例（75%）正位,单眼内直肌前徙＋单眼外直肌后徙20例术后18例（90%）正位;1周～6周斜视度数变化-5.2△±0.4△,6周～6个月变化-1.2△±0.4△,1周～1年变化-6.4△±2.1△。1周～6周有25例患者（58.1%）有外斜视漂移,变化-8.0△±1.4△,其中术中过矫组的10例继发外斜视患者,术后6周内均出现了外斜视漂移,平均为-8.3±2.0△。结论外直肌后徙联合后徙的内直肌前徙是治疗继发性外斜视的有效方式。术中5△～10△小度数过矫可提高远期的术后正位率。     

单眼外直肌后徙内直肌缩短术与双眼外直肌后徙术之比较

目的 对照研究单眼外直肌后徙内直肌缩短与双眼外直肌后徙两种手术方式对共同性外斜视的手术效果、术后并发症、双跟单视功能、复发率方面的差异.方法 将2003年8月～2007年4月住院的共同性外斜视197例(均为基本型),斜视度30△～60△,分两组,A组行单眼外直肌后徙内直肌缩短手术,B组行双眼外直肌后徙手术.术后同视机训练1周,随诊半年,收集临床资料.结果 1.术后一月眼位正位率A组89%,B组85%,差异无统计学意义(P=0.18);术后半年眼位正位率A组81%,B组67%,差异具有统计学意义(P=0.04);2.术后半年,眼球运动受限(外转欠2mm以上)及侧方复视发生率A组24%,24%,B组51%,39%,差异具有统计学意义(P=0.04);3.术后一月,建立Ⅰ、Ⅱ、Ⅲ、级视功能比例:A组63%、40%、41%,B组68%、37%、30%,差异无统计学意(P=0.12);术后半年,建立Ⅰ、Ⅱ、Ⅲ级视功能比例:A组51%、32%、32%,B组32%、21%、19%,差异具有统计学意义(P=0.02);4.复发(眼位回退>-10°)率:A组16%.B组34%.差异具有统计学意义(P=0.04).结论 两种手术方式对矫正共同性外斜视各有优缺点,采用单眼外直肌后徙内直肌缩短手术的远期效果要好于双眼外直肌后徙术.     

双眼直肌后徙术与单眼直肌后徙联合对侧直肌截短术之比较

目的 评价双眼直肌后徙术与单眼直肌后徙联合对侧直肌截短术,治疗共同性基本型内斜视和基本型外斜视的效果.方法 选择水平共同性斜视患者511例,斜视度数为20～50△,分成A、B两组,分别行双眼直肌后徙术、单眼一条直肌后徙+对侧直肌截短术,再根据基本型内斜、基本型外斜及斜视度数大小不同分为:A1a、A1b、A2a、A2b、B1a、B1b、B2a、B2b计8组.总结、分析术后1月及6月的视力,眼位,眼球运动状态,有无复视,双眼单视功能,结膜局部瘢痕及半整度.结果 A1a组术后6月眼球正位率显著高于B1a组(x2=5.49,P=0.0191)、A2a组亦高于B2a组(x2=9.14,P=0.0025);A1b组术后6月眼球正位率显著低于B1b组(x2=7.86,P=0.0050)、A2b组亦低于B2b组(x2=16.76,P<0.0001);A组术后6月具备Ⅰ级以上视功能患者比例明显高于B组(x2=14.81,P=0.0001).结论 无论外斜视或内斜视,对于相对低斜视度数的患者,双眼后徙术优于单眼后徙+截短术,对于相对高斜视度数患者,单眼后徙+截短术眼位一次矫正率高于双眼后徙术;双眼后徙术术后舣眼单视功能好于单眼后徙+截短术.     

不同手术方式治疗集合不足型间歇性外斜视疗效观察

目的探讨不同手术方式治疗集合不足型间歇性外斜视的疗效。方法将76例集合不足型间歇性外斜视患者,根据手术设计方式分为A、B两组,A组行双眼外直肌后徙术,B组行单眼内直肌缩短联合外直肌后徙术。术后随访,比较两组术后正位率、融合功能恢复率、立体视功能恢复率及残余性外斜视、连续性内斜视发生率。结果术后随访眼位总体正位率82.89%,A组为69.23%B组为90%,P〈0.05。术后融合功能恢复率、立体视功能恢复率、残余性外斜视和连续性内斜视发生率两组间差异均有显著性（P〈0.05）。结论采用单眼外直肌后徙联合内直截除术治疗集合不足型间歇性外斜视,术后正位率、融合功能和立体视功能恢复均优于双眼外直肌后徙术。     

集合不足型外斜视外直肌斜向后徙

目的　评价集合不足型外斜视外直肌斜向后徙的效果。方法　研究组 2 2例 ,对照组 8例 ,看近斜视角大于看远斜视角至少 15PD ,研究组 2 2例行外直肌斜向后徙术 ,对照组 8例行标准的外直肌后徙术。结果　研究组 18/2 2术后看近外斜度≤ 10PD ,2 2 /2 2术后看远外斜度≤ 10PD ,看近看远外斜角平均差值由术前 2 5± 8 11PD减少到术后 5 2 3± 4 0 3PD。对照组仅 3 /8术后看近外斜度≤10PD ,6/8术后看远外斜度≤ 10PD。结论　集合不足型外斜视外直肌斜向后徙术效果优于标准的外直肌后徙术。     

大角度外斜视手术方法的探讨

目的探讨大角度外斜视安全、有效、简便的手术方法,观察手术效果。方法39例外斜视病例按照斜视度大小分为A、B、C三组,采用外直肌超常量后徙术、外直肌常量后徙加内直肌缩短术以及外直肌超常量后徙加内直肌缩短术三种术式,术后1月测量原在位斜视度。结果A组中三种术式正位率无显著性差异,B组中三种术式正位率有显著性差异,C组选用的二种术式正位率无显著性差异。结论传统的外直肌常量后徙加内直肌缩短术在眼位正位率上更具有稳定性。外直肌超常量后徙术对于一定度数内的大角度外斜视有效。随着外斜视度数的增大,可采用外直肌超常量后徙术合并内直肌缩短术。     

集合不足型外斜视手术的近期疗效

目的探讨共同性外斜视集合不足型的近期手术疗效。方法采用常规单眼外直肌后徙+内直肌缩短手术治疗集合不足型共同性外斜视。结果显示所有42例病例术后正位率90.5%,并且远近斜视度差值明显减小。结论采用单眼外直肌后徙+内直肌缩短手术治疗集合不足型共同性外斜视效果肯定。     

单纯与双内直肌后徙联合Faden术矫正集合过强型内斜视的比较分析

目的 比较单纯双内直肌后徙与双内直肌后徙联合Faden术在矫正集合过强型内斜视中的作用。方法 28例集合过强型内斜视,远近斜视角相差在15△以上,AC/A值〈6,看近斜视角为45～80△,看远25～45△,一组12例行单纯双内直肌后徙,另一组16例行双内直肌后徙联合Faden术。结果 12例行单纯双内直肌后徙组中9例视近仍残余＞10△内斜视。16例行双内直肌后徙联合Faden术组14例视近时基本正位,2例视近仍残余＞10△内斜视,2例视远过矫。结论 双内直肌后徙联合Faden术较单纯双内直肌后徙可有效矫正集合过强型内斜视,但需要注意防止过矫。     

双眼内直肌后退术治疗高AC/A非屈光性调节性内斜视

目的对高AC/A的非屈光性调节性内斜视患者,进行双眼内直肌后徙术,观察手术疗效.方法选取15例高AC/A的非屈光性调节性内斜视患者进行双眼内直肌后徙术,后徙量依据斜视度数而定,术后观察眼位,AC/A值及双眼单视功能.结果15例患者术后视远斜视度数平均减少36.80棱镜度,视近斜视度数平均减少48.80棱镜度;9例患者术后双眼立体视锐度有不同程度的提高;13例患者术后不再需要双光镜.2例患者视近斜视度数没有得到改善,术后仍需戴双光镜.结论对高AC/A的非屈光性调节性内斜视患者进行双眼内直肌后徙术,是一种有效的治疗方法.     

外直肌倾斜后徙术与外直肌后徙术治疗集合不足型外斜视的效果比较

目的：观察外直肌倾斜后徙术（S-LR）与外直肌后徙术（LR）对集合不足型外斜视[CIX（T）]患者的 治疗效果。方法：回顾性研究。收集2017年1月至2019年8月于上海交通大学医学院附属新华医院 由同一术者施行的斜视矫正术的CIX（T）患者101例，根据术式分为双眼外直肌倾斜后徙术（S-BLR） 组44例和双眼外直肌后徙术（BLR）组57例，随访3个月，观察比较行不同术式的患者术后视近斜视 角、视远斜视角及远近斜视角度差（NDD）。使用Mann-Whitney U检验、卡方检验、t检验等进行统 计学分析。结果：术后3个月，NDD较术前的改善量在S-BLR组和BLR组分别为（8.0±3.3）棱镜度（PD） 和（6.1±4.0）PD，S-BLR组较BLR组对NDD的改善更明显（Z=-1.995，P=0.046）。术后3个月，视近 斜视角S-BLR组为（-5.1±5.5）PD，较BLR组的（-8.3±5.8）PD明显减小（Z=-2.882，P=0.004）。视 远斜视角在S-BLR组与BLR组手术前后，差异无统计学意义。术后3个月正位率在S-BLR组为82%， 高于BLR组的53%（χ2 =9.34，P=0.002）。S-LR前后，S-BLR组患者上视及下视斜视角度差及黄斑中 心凹-视盘中心夹角度数差异均无统计学意义。结论：S-LR对CIX（T）的视近斜视角及NDD疗效优 于LR，是一种安全有效的术式。     

Unilateral recession-resection in children with exotropia of the convergence insufficiency type

PURPOSE: The surgical success rates for intermittent exotropia of the convergence insufficiency type have been reported to be variable, and most were studied retrospectively in adults. The purpose of this study was to evaluate prospectively the long-term surgical results of unilateral lateral rectus (LR) muscle recession and medial rectus (MR) muscle resection in children with intermittent exotropia of the convergence insufficiency type. METHODS: A total of 14 children with intermittent exotropia greater at near than at distance by 10 prism diopters (PD) or more were included in this prospective study. The amounts of resection and recession were based on near and distance deviation, respectively. Minimum follow-up was 1 year (mean 26.6 months; range, 12-68 months) after surgery. The paired t-test was used to compare preoperative and postoperative measurements of the angle of deviation at distance and near, near-distance difference. RESULTS: Significant postoperative reduction was achieved in terms of mean distance exodeviation, from 22.5 PD to 9.1 PD (P=0.000), and mean near exodeviation from 33.8 PD to 13.6 PD (P=0.000). Mean near-distance difference reduced from 11.3 PD preoperatively to 4.6 PD postoperatively (P=0.000). Fresnel prism was used temporarily to treat postoperative esotropia in only one patient for postoperative 6 months. CONCLUSIONS: Unilateral surgery biased to MR strengthening more than LR weakening in children with intermittent exotropia of the convergence insufficiency type, was found to successfully reduce both distance and near deviation and to collapse near-distance differences with a low risk of long-term postoperative esotropia.     

改良外斜视矫正术治疗儿童小度数集合不足型间歇性外斜视的临床观察

目的研究改良的外斜视矫正手术治疗儿童小度数集合不足型间歇性外斜视的手术疗效。方法 31例视近斜视度在20^△~30^△的集合不足型间歇性外斜视行改良的外斜视矫正手术,分别观察手术前后视远和视近的斜视度、视远和视近的斜视度的差值、术后的正位率、A-V型斜视、眼球运动以及立体视的变化。随访时间6~12个月。结果术后视近和视远的斜视度平均比较(t=8.72,P<0.05)和(t=3.46,P<0.05),视远和视近的斜视度的差值比较(t=5.75,P<0.05),平均立体视锐度为361.2"(t=3.25,P<0.05),正位率83.9%(26/31),术后没有出现A-V型斜视和眼球运动受限。结论对于小度数集合不足型间歇性外斜视,改良的外斜视矫正手术在减小视远和视近的斜视度,降低视远和视近的斜视度的差值,恢复立体视,提高术后的正位率均安全有效。     

对小度数集合不足型间歇性外斜视手术疗效分析

目的 探讨单纯单眼内直肌截除术和2.5～3.0mm单眼外直肌后徙+单眼内直肌截除术对视近时斜视度在15△～25△之间的小度数集合不足型间歇性外斜视的手术疗效.方法 对10例患者行2.5～3.0mm单眼外直肌后徙+单眼内直肌截除术(A组),15例患者行单纯单眼内直肌截除术(B组),术后分别比较两组患者视远和视近的斜视度以及视远和视近的斜视度的差值,并比较两组患者术后的正位率、恢复双眼视例数和恢复近立体视例数.术后随访6至12个月.结果 两组术前和术后视远和视近的斜视度以及视远和视近的斜视度的差值比较经t检验差异均有统计学意义(t=1.73～9.73,P＜0.05),A、B两组术后正位率、术后恢复双眼视的例数和恢复立体视例数经x2检验差异具有统计学意义(x2=3.84～5.11,P＜0.05).结论 (1)2.5～3.0mm单眼外直肌后徙+内直肌截除术和单纯单眼内直肌截除术治疗视近时斜视度15△～25△的小度数集合不足型间歇性外斜视均有效.(2)在缩小视近和视远斜视度的差值、术后正位率、恢复双眼视和立体视功能方面,2.5～3.0mm单眼外直肌后徙+内直肌截除术优于单纯单眼内直肌截除术.

Abstract：

Objective To evaluate the surgical results of unilateral medial rectus muscle resection and 2.5mm-3.0mm unilateral lateral muscle recession with unilateral medial rectus muscle resection for the intermittent exotropia of the convergence insufficiency type with small-diopter exodeviation of 15 △ to 25 △ at near.Methods Ten cases received 2.5mm-3.0mm unilateral lateral muscle resection with unilateral medial rectus muscle resection (group A),15 cases received unilateral medial rectus muscle resection (group B).The distance and near deviations and differences in the deviations were compared separately for the two groups;besides,the positioning rates,number of patients with restoration of binocular and stereoscopic visions were compared in the two groups after surgery.They were followed-up for 6 to 12 months after surgery.Results There was statistically significant difference (t =1.73-9.73,P ＜0.05) in the angle at near and distance,the angle near-distance difference.There also was statistically significant difference (x2=3.84-5.11,P ＜0.05) in the orthophoria rate,biocular vision recovery,stereopsis recovery after operation were compared between group A and B.Conclusions Both of the unilateral medial rectus muscle resection and 2.5mm-3.0mm unilateral lateral muscle recession with unilateral medial rectus muscle resection are an effect surgical treatment for the intermittent exotropia of the convergence insufficiency type with small-diopter exodeviation of 15△ to 25△ at near.2.5mm-3.0mm unilateral lateral muscle recession with unilateral medial rectus muscle resection is superior to unilateral medial rectus muscle resection in reducing the angle difference of near-diatance,orthophoria rate,biocular vision recovery,stereopsis recovery.     

The long-term result of slanted medial rectus resection in exotropia of the convergence insufficiency type

PURPOSE: To evaluate the long-term results of slanted medial rectus (MR) resection for intermittent exotropia (X(T)) of the convergence insufficiency type. METHODS: In all, 10 patients with an X(T) greater at near than at distance by 10 prism diopters (PD) or more were included in this prospective study. Patients received slanted bilateral MR resection. The upper edge of the MR was resected according to the distance exodeviation and the lower edge of the MR was resected according to near exodeviation. The postoperative follow-up period was between 6 and 62 months with a mean of 38.9 months. The paired t-test was used to compare: mean distance angle of deviation preoperatively and postoperatively; mean near angle of deviation preoperatively and postoperatively; and mean near-distance exodeviation difference preoperatively and postoperatively. RESULTS: Bilateral slanted MR resections reduced mean exodeviation at distance from 23.0+/-7.2 to 16.3+/-5.4 PD (P=0.03); mean exodeviation at near from 34.3+/-7.7 to 24.6+/-6.9 PD (P=0.01); and mean near-distance difference from 11.4+/-2.6 to 8.3+/-3.5 PD (P=0.04). At the final follow-up examination, all patients demonstrated an exodeviation of 10 PD or more at distance and near, and the exodeviation difference between distance and near deviation was within 10 PD in five of the 10 patients. Three patients had an esodeviation at distance after surgery, but all resolved within 4 weeks. CONCLUSIONS: Bilateral slanted MR resections in patients with X(T) of the convergence insufficiency type resulted in undercorrection in all patients.     

Observation of Surgical Effects of Slanted Lateral Rectus Recession and Lateral Rectus Recession on Convergence Insufficiency Intermittent Exotropia

Objective: To observe the surgical effects of slanted lateral rectus recession (S-LR) and lateral rectus recession (LR) on convergence insufficiency intermittent exotropia [CIX (T)]. Methods: In this retrospective study, surgery was performed by the same surgeon on 101 patients with CIX (T) in Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2017 to August 2019. They were divided into 2 groups: A bilateral slanted lateral rectus recession group (S-BLR group, 44 cases) and a bilateral lateral rectus recession group (BLR group, 57 cases). All patients were followed up for 3 months. The postoperative near deviation, distant deviation, and near-distant disparity (NDD) were measured and compared in this retrospective study. Data were analyzed using Mann-Whitney U test, χ2 test, t test. Results: Three months after surgery, the improvement of NDD was 8.0±3.3 PD in the S-BLRgroup and 6.1±4.0 PD in the BLR group (Z=-1.995, P=0.046). NDD improved more significantly in the S-BLR group than in the BLR group. The near deviation of the S-BLR group (-5.1±5.5 PD) significantly decreased compared with the BLR group (-8.3±5.8 PD) (Z=-2.882, P=0.004). There was no significant difference in distant deviation between the S-BLR group and LR group after 3 months. The success rates after 3 months of follow-up were 82% in the S-BLR group, which was a higher rate than 53% in the BLR group (χ2 =9.34, P=0.002). There was no significant difference between preoperative and postoperative fovea-disc angles and A and V patterns in the S-BLR group. Conclusions: In postoperative near deviation and NDD, S-LR patients improve more significantly than LR patients. S-LR does not cause A and V pattern strabismus or fundus rotation. S-LR patients have a better surgical outcome than LR patients with CIX (T).     

Slanted lateral rectus recession for exotropia with convergence weakness.

OBJECTIVE: To evaluate the efficacy of slanted recession of the lateral rectus (LR) muscle for exotropia (XT) with convergence weakness. DESIGN: Predesigned, nonrandomized, comparative trial. PARTICIPANTS: Twelve study patients and six control subjects with XT greater at near than at distance by > or =10 prism diopters (PD). INTERVENTION: Twelve consecutive patients underwent slanted LR recession, and six consecutive control subjects underwent standard LR recession. MAIN OUTCOME MEASURES: Between-groups comparison of the postoperative ocular alignment at distance and near, and the difference between them, as well as the stereopsis. RESULTS: Slanted LR recession reduced the XT to <8 PD in all patients at distance and in 11/12 patients at near. Additionally, the mean difference between the distance and near exodeviation was reduced from 14+/-4.5 PD preoperatively to 2.9+/-2.4 PD postoperatively. All patients in the control group demonstrated postoperative deviations of <8 PD at distance, but all had residual exodeviations >8 PD at near. Three of the study patients gained gross stereopsis postoperatively. CONCLUSIONS: Slanted recession of the LR is superior to standard recession in reducing both distance and near XT and in collapsing the difference between them. This technique may also have a positive impact on gross stereopsis.     

大角度外斜视两种手术矫正方法的对比分析

目的 将大角度外斜视外直肌超常量后退术和外直肌边缘楔形切开术进行比较,观察手术效果.方法 两组共37例,手术前后均用角膜映光法和三棱镜遮盖法测定斜视度.A组(18例)行外自肌超常量后退联合内直肌截短术,B组(19例)行外直肌边缘楔形切开联合内直肌截短术.并能两组进行统计学分析.结果 两组术前斜视度无统计学显著差异(P＞0.05),术后1～6个月复诊眼位的比较:A组16例≤±10△,正位率88.89%,B组17例≤±10△,正位率89.47%,两组正位率比较差异无统计学意义(x2=0.03 P＞0.05).结论 外直肌超常量后退和外直肌楔形切开术均可以有效地矫正大角度外斜视.

Abstract：

Objective To compare lateral rectus marginal myotomy with wedge excision combined with resection of medial rectus with over-routine-quantity recession of lateral rectus and resection of medial rectus in treatment of large angle exotropia and observe the clinical effect.Methods Thirty-seven cases of large angle exotropia were divided into 2 groups.Group A(18 cases)underwent over-routine-quantity recession of lateral rectus and resection of medial rectus,Group B(19 cases)underwent lateral rectus marginal myotomy with edge excision and resection of medial rectus.All patients were measured the deviation before and after operation by using Hirschberg test and prism cover test.The surgery was performed according to the amount of distance deviation.All the surgeries were performed by the same ophthalmologist.A successful alignment was defined as ± 10△ or less in primary gaze while viewing distant and near targets.Results Before operation,the difference of strabismus angle between the two groups was no statistically significant(P ＞0.05),the cosmetic success rate(±10△)was (88.89%)in group A and(89.47%)in group B.The difference between the two groups was not statistically significant(x2=0.03,P＞0.05).Conclusions There is no significant difference between over-routine-quantity recession of lateral rectus combined with resection of medial rectus and lateral rectus marginal myotomy with edge excision combined with resection of medial rectus for large angle exotropia.     

Unilateral lateral rectus muscle recession and medial rectus muscle resection with or without advancement for postoperative consecutive exotropia.

PURPOSE: To evaluate the effectiveness of unilateral lateral rectus muscle recession and medial rectus muscle resection with or without advancement in treating postoperative consecutive exotropia. METHODS: We performed a retrospective review on 31 patients with consecutive exotropia who were treated with unilateral lateral rectus muscle recession and medial rectus muscle resection (17 patients) or unilateral lateral rectus muscle recession and medial rectus muscle partial resection combined with advancement (14 patients). All patients had exotropia with a less than 10 prism diopters (PD) distance near-disparity. The characteristics studied before surgery included type of esotropia surgery, detection of amblyopia, presence of an "A" or "V" pattern, dissociated vertical deviation, limitation of adduction, deviation angle measurement, and forced duction testing. Ocular alignment and status of adduction postoperatively at the last follow-up were recorded. RESULTS: Nineteen patients (61.3%) had amblyopia, 17 patients (54.8%) had limitation of adduction, 8 patients (25.8%) had dissociated vertical deviation, and 5 patients (16.1%) had an "A" or "V" pattern. The mean preoperative exodeviation was 47.3 PD. Overall 21 (67.7%) of 31 patients achieved a successful postoperative result (alignment within 10 PD of orthophoria). There was no significant difference in successful alignment in patients treated with unilateral medial rectus muscle resection compared with those treated with unilateral medial rectus muscle partial resection combined with advancement. There was no influence of amblyopia on the result. Twelve (70.6%) of the 17 patients with limited adduction preoperatively showed normalization of adduction postoperatively. CONCLUSIONS: Unilateral lateral rectus muscle recession and medial rectus muscle resection with or without advancement is an effective alternative for treating postoperative consecutive exotropia.     

Analysis of the effects of medial rectus muscle resection for recurrent exotropia

Purpose

The purpose of this paper is to investigate how much correction is obtained per millimeter of medial rectus (MR) resection for recurrent exotropia after bilateral lateral rectus (BLR) recession, and to determine the difference in the effects between unilateral and bilateral resection, and the influence of previous lateral rectus (LR) recession on the effects of MR resection.

Methods

A total of 59 patients who had undergone MR resection after BLR recession were included in this study. The unilateral group consisted of 38 patients and bilateral group, 21 patients. Thirty patients in the unilateral group were divided into two groups: patients who had undergone previous LR recession of 7 mm or greater (21 patients) and less than 7 mm (9 patients). Main outcome measures were average deviation corrected per millimeter of MR resection at 1 month postoperative.

Results

The average effect of MR resection was 4.2 prism diopters (PD, 2.0 to 6.7 PD)/mm. The average effect in the unilateral group was 4.2 PD/mm and 4.1 PD/mm in the bilateral group. There was no significant difference between groups (P = 0.60). The average effect in the recession 7 mm or greater group was 4.0 PD/mm, and the average effect in the recession less than 7 mm group was 4.2 PD/mm (P = 0.698).

Conclusions

The effect of MR resection per millimeter was variable. The laterality and previous amount of LR recession did not influence the effect of MR resection. These variable outcomes dictate that caution be exercised when MR resection is performed for recurrent exotropia.