Comparison of Rectus Muscle Resection and Rectus Muscle Plication for Ocular Horizontal Strabismus Comparison of Rectus Muscle Resection and Rectus Muscle Plication for Ocular Horizontal Strabismus
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Keywords
Plication, Resection, Strabismus, Rectus Muscle, Esotropia, Exotropia
Abstract
Objectives: This study aimed to compare the surgical outcomes of rectus muscle plication with those of standard rectus muscle resection in combination with recession in patients with horizontal ocular deviations.
Methods: This comparative prospective case-control study was conducted in the Department of Ophthalmology of Basra Teaching Hospital in Iraq from March 2017 to August 2019. Fifty-eight patients (25 male, 33 female; mean age = 3.86 years), including 32 with esotropia and 26 with exotropia, were divided randomly into two treatment groups after a comprehensive preoperative assessment and selection process. They underwent the indicated rectus muscle tightening procedures. During a postoperative follow-up, a surgical success was defined as an alignment of ≤5 prism diopter (PD). Patients with different characteristics were compared statistically, and differences with P-values of ≤0.05 were considered statistically significant.
Results: Thirty cases (51.7%; 95% confidence interval [CI]: 37.9–65.5%) underwent rectus muscle resection and 28 (48.3%; 95% CI: 34.5–62.1%) underwent rectus muscle plication. Surgical success was achieved in 55 of 58 patients (94.8%; 95% CI: 89.7–100.0%), and there was no statistically significant difference in the achievement of postoperative alignment (≤5 PD) between the groups.
Conclusions: Both surgical procedures for the treatment of esotropia and exotropia coupled with rectus muscle recession yielded equivalent postoperative surgical alignment results. Plication provided advantages such as a reduced surgical trauma, fewer bloody fields, no slipped muscles, and a reversible outcome.
Keywords: Plication, Resection, Strabismus, Rectus Muscle, Esotropia, Exotropia
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