Surgical Correction of V Pattern Intermittent Exotropia Without Inferior Oblique Muscle Overaction

Tanta University

Status: Completed

Conditions: Overaction; Intermittent Exotropia; V Pattern; Surgical Correction; Inferior Oblique Muscle

Treatments: Procedure: Bilateral Lateral Rectus Recession with Upward Transposition; Procedure: Bilateral Lateral Rectus Recession (BLR Recession)

Study type: Interventional

Funder types: Other

Identifiers

NCT07180199

36264MS244/7/23

Details and patient eligibility

About

Evaluation of the results of surgical correction of V pattern intermittent exotropia without inferior oblique muscle overaction by either performing bilateral lateral rectus recession (BLR) alone or performing bilateral lateral rectus recession asssosiated with upward transposition of lateral rectus muscle insertion

Full description

Intermittent exotropia (IXT) is the most common type of strabismus which is a disorder of binocular eye movement control in which one eye intermittently moves outwards.Intermittent exotropia may be associated with difference in the horizontal deviation from the primary position to the upward or downward gaze giving A or V pattern In V-pattern intermittent exotropia (XT), there is an increase in the horizontal deviation as the eyes move from downgaze to upgaze.

Non-surgical treatment includes correction of refractive error, orthoptics, overcorrecting minus lenses and prismotherapy. Surgical options includes unilateral medial rectus muscle resection combined with a lateral rectus muscle recession or bilateral lateral rectus recession as in basic type IXT OR bilateral lateral rectus muscle recession as in divergent excess type OR bilateral medial rectus muscle resection as in convergence insufficiency.

Enrollment: 20 patients

Sex: All

Ages: 5+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Patients with V pattern intermittent exotropia (XT increasing by >10Δ in upgaze compared with Downgaze).
• No or minimal inferior oblique overaction on both sides (+1)
• Minimum follow-up period of 6 months after surgical correction of strabismus

Exclusion criteria

• Structural eye pathology.
• Significant neurodevelopmental delay.
• ntermittent exotropia without V pattern.
• Superior oblique under action.
• Duane syndrome.
• Less than 6 months follow up.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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20 participants in 2 patient groups

Bilateral Lateral Rectus Recession (BLR Recession)

Experimental group

Description:

Participants underwent bilateral lateral rectus recession procedure alone for correction of large-angle exotropia.

Treatment:

Procedure: Bilateral Lateral Rectus Recession (BLR Recession)

Bilateral Lateral Rectus Recession with Upward Transposition

Experimental group

Description:

Participants underwent bilateral lateral rectus recession combined with upward transposition of the muscle insertion to enhance alignment in cases of large-angle exotropia.

Treatment:

Procedure: Bilateral Lateral Rectus Recession with Upward Transposition