Surgical responses and outcomes of bilateral lateral rectus recession in exotropia with cerebral palsy

Acta Ophthalmol. 2017 May;95(3):e179-e184. doi: 10.1111/aos.13158. Epub 2016 Jul 16.

Abstract

Purpose: To determine surgical responses and outcomes of bilateral lateral rectus (BLR) recession in exotropes with cerebral palsy (CP) and to compare the results with exotropes without CP.

Methods: Forty-one exotropes with CP and 82 age- and type (intermittent or constant)-matched exotropes without CP who underwent BLR recession by one surgeon (J-M.H.) were evaluated. Main outcome measures were surgical responses, factors affecting surgical response, success rates, cumulative probabilities of success and recurrence, and drifts of ocular alignment towards exodeviation after surgery (exodrift).

Results: The surgical responses of BLR recession were not significantly different between both groups (p = 0.136). After a mean follow-up period of 2 years, success rates showed no significant difference between the two groups (p = 1.000). The cumulative probabilities of success and recurrence were not significantly different between the two groups (p = 0.770 and 0.754, respectively). The rate of recurrence per person-year during follow-up was 16.7% in patients with CP and 20.2% in patients without CP. The amount of exodrift showed no significant difference between both groups (p = 0.118).

Conclusions: Exotropes with CP showed a similar surgical response, an amount of exodrift, cumulative success and recurrence rates after BLR recession compared to exotropes without CP.

Keywords: cerebral palsy; exotropia; surgical outcome; surgical response.

Publication types

  • Observational Study

MeSH terms

  • Case-Control Studies
  • Cerebral Palsy / complications*
  • Child, Preschool
  • Exotropia / complications
  • Exotropia / physiopathology
  • Exotropia / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Oculomotor Muscles / surgery*
  • Ophthalmologic Surgical Procedures / methods*
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Vision, Binocular / physiology*
  • Visual Acuity