Supermaximal Recession and Resection in Large-Angle Sensory Exotropia

• Published in: Korean journal of ophthalmology Vol. 25; no. 2; pp. 139 - 141
• Main Authors: Chang, Jee Ho, Kim, Hoon Dong, Lee, Jong Bok, Han, Sueng-Han
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Ophthalmological Society 01.04.2011; 대한안과학회
• Subjects: Adult; Case Report; Exotropia - physiopathology; Exotropia - surgery; Eye Movements; Female; Follow-Up Studies; Humans; Male; Middle Aged; Oculomotor Muscles - physiopathology; Oculomotor Muscles - surgery; Postoperative Period; Vision, Ocular; 안과학; Large sensory exotropia; Recession and resection; Supermaximal
• ISSN: 1011-8942; 2092-9382; 2092-9382
• DOI: 10.3341/kjo.2011.25.2.139

In cases of extropia with an exodeviation angle over 50 prism diopter (PD), a 3- or 4-muscle surgery is a rational option. But, in patients with sensory exotropia, there is usually a strong preference for a monocular procedure to avoid surgery on the single seeing eye. Thus, we confined surgery to visually poor eyes, and performed a medial rectus muscle resection with a mean of 10.3 mm (range, 9-11 mm) and a lateral rectus muscle recession with a mean of 12.8 mm (range, 10-14 mm) in 4 adult sensory exotropia patients who had a mean deviation of 82.3 PD (range, 75-90 PD). The mean postoperative angle of exodeviation was 2.0 PD (range, ortho-8 PD). The limitation on abduction was not disfiguring. Other expected disfigurements, such as narrowing of the palpebral fissure or enophthalmos, were not conspicuous. The mean follow-up period was 4.5 months (range, 3-7 months). In large-angle sensory exotropia, instead of additive surgery on the seeing eye, supermaximal medial rectus resection and lateral rectus recession only on the visually poor eye is a clinically feasible surgical option.