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Bilateral Lateral Rectus Recession vs Unilateral Recess-Resect Procedure for Exotropia With a Dominant Eye

EDITOR: The purpose of the study by Jeoung and Associates 1 was to compare surgical outcomes of bilateral lateral rectus (BLR) recession with unilateral recess-resect (RR) on the nondominant eye for intermittent or constant exotropia. Not many papers had shown such good semiology to determine distance and near deviation. However, the authors did not analyze the main concern regarding exotropia surgery: the instability of surgical results, what increases late recurrences. 2,3 It would be important to know the progression of deviation changes in each group after the first day, first week, first month, and six months post surgery. Comparing the mean deviation change of both groups at six months would help to indicate better the most beneficial procedure. In 1982, we started studying the instability of surgical results in exotropia. We observed that most patients showed an exo imbalance of the dominant eye under general anesthesia. This finding, in theory, could explain the increased frequency of late recurrences when the dominant eye is not included in the surgical plan. Rationally, if the mechanical exo imbalance of the fixing eye is not corrected, it can act as a fuel which increases the exo imbalance of the nondominant eye. Only http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Ophthalmology Elsevier
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