Unilateral Medial Rectus Resection versus Plication in Residual Intermittent Exotropia after Bilateral lateral Rectus Recession

Surgical approaches for correcting residual or recurrent strabismus depend on the former operation pattern and on the angle of deviation. Unilateral medial rectus resection (UMRR) shows good outcomes for small angle, ≤25 PD. Muscle plication is an alternative, but still there is not enough literature comparing plication results with resection. To compare between unilateral medial rectus resection (UMRR) versus unilateral medial rectus plication (UMRP) in treatment of residual Intermittent exotropia X(T) after bilateral lateral rectus recession (BLR). 30 patients with residual X(T) angle ranged from 10-25PD after BLR, age ranged from 3-30 years were included in our prospective cohort study, they were divided into two groups: Group I (14 patients) underwent UMRP and Group II (16 patients) underwent UMRR. Follow-up period was three months following surgery. Success was defined as angle of deviation between 8 PD esodeviation and exodeviation. Postoperative, the success rate was 92.9% in group I and 87.5% in group II, without significant difference (p=1.000). By the end follow-up 92.9% in group I and 75.0% in group II has no limitation of abduction, with no statistically significant difference (p=1.000). UMRP for correction of residual X (T) is better than UMRR in success rate and in abduction deficits, 3 months after surgery, but it was not a statistically significant difference.