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- W4243162396 abstract "We thank Rath and colleagues for their comments. We agree that having multiple surgeons and techniques may influence the results. Our purpose was to report the results of a three-muscle surgery for horizontal strabismus and not to compare different approaches. In our study all patients underwent three-muscle surgery. With regard to the surgical dose, the method used in our series was very successful in correcting patients with large-angle esotropia and exotropia. The most stable results were obtained in patients with esotropia. Our results suggested that the effect of surgery was most associated with the preoperative deviation than with the amount of surgery, as described by Archer and Kushner.1Archer S.M. The effect of medial versus lateral rectus muscle surgery on distance-near incomitance.J AAPOS. 2009; 13: 20-26Abstract Full Text Full Text PDF PubMed Scopus (27) Google Scholar, 2Kushner B.J. Fisher M.R. Lucchese N.J. Morton G.V. Factors Influencing Response to Strabismus Surgery.Arch Ophthalmol. 1993; 11: 75-79Crossref Scopus (72) Google Scholar In our series, 1 patient with a comitant constant 45Δ exotropia underwent bilateral rectus recession of 7 mm and right medial rectus muscle resection of 5 mm. Postoperative alignment demonstrated a residual 16Δ of exotropia in primary position and in right gaze at distance and 10Δ in left gaze. He was orthotropic at near, had no diplopia and demonstrated bifoveal fixation. Two adults with acquired esotropia larger at distance, with −1 limitation to abduction and negative forced duction testing underwent bilateral lateral rectus muscle resections and unilateral medial muscle recession. We only included patients without amblyopia since we did not want to influence our motor and sensory examination by other factors. We agree that our population included patients in whom two-muscle surgery could have been performed. However, it is our experience that unilateral surgery may result in undesirable lateral incomitance, lateral gaze diplopia, limited ocular rotations, and eyelid asymmetry, especially in patients without sensory strabismus. Four esotropic and 6 exotropic patients with deviations equal or larger than 50Δ were included. The success rate for those patients using a three-muscle approach was 100%." @default.
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- W4243162396 date "2018-06-01" @default.
- W4243162396 modified "2023-10-18" @default.
- W4243162396 title "Reply" @default.
- W4243162396 doi "https://doi.org/10.1016/j.jaapos.2018.04.001" @default.
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