Article
Asymmetric dosage in combined recession-resection procedure
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Authors
Published: | September 22, 2004 |
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Outline
Text
Objective
We investigated whether asymmetric dosage in combined recession-resection procedure with a relation of 1:2 shows more effect on the distant angle than on the near angle and may therefore cause a postoperative convergence excess.
Methods
Retrospective analysis of 90 patients aged 4 to 13 with congenital esotropia, who underwent unilateral asymmetrically dosed combined recession-resection surgery between 2002 and 2003. We evaluated pre- and postoperative distant and near angles measured by the alternating prism cover test. In addition binocular functions and the amount of further eye muscle surgeries were investigated.
Results
The amount of recession was 3,22 ±0,28 mm (mean ± standard deviation), the amount of resection 7,32 ±0,59 mm. The total amount was 10,54 ±0,63 mm. The relation of recession to resection was 1:2,29 ±0,28. Preoperative distant angles were C 23,11 ±5,67°, 3 days postoperatively distant angles decreased to C 4,99 ±5,35° and after 6 weeks to C 6,95 ±6,04°. Preoperative near angles were C 27,15 ±6,55° and decreased to C 8,35 ±5,85° 3 days post surgery and to C 10,94 ±6,76° at the 6 weeks control. Distant angles had diminished by 16,17 ±5,07 mm at the 6 weeks control, near angles by 16,21 ±6,15 mm. This corresponds to an effectivity of 1,53 ±0,47°/mm on distant angles and of 1,54 ±0,58°/mm on near angles. Simultaneous perception measured by striated lenses of Bagolini was postoperatively found in 18 patients for distant gaze, in 29 patients for near gaze. In 9 patients a second operation was performed several months later, in most cases a bilateral Fadenoperation on the medial rectus muscle.
Conclusions
Combined recession-resection procedure with a small amount of recession in regard to the amount of resection (relation 1:2,3) equally reduce distant and near angles and do not lead to a subsequent postoperative convergence excess.