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Original article

Inferior rectus recession: outcome of surgery

Authors:

G. Cormack ,

Department of Ophthalmology, Ninewells Hospital and Medical School, Dundee DD1 9SY, GB
About G.

BSc

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C. MacEwen

Department of Ophthalmology, Ninewells Hospital and Medical School, Dundee, GB
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MD FRCS FRCOphth

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Abstract

Aim: Inferior rectus recession (IRR) surgery has been reported to be unstable, and there have been particular concerns about progressive overcorrec­tion. This study reviewed the vertical outcomes following IRR surgery in order to observe post­operative stability.

Methods: A retrospective review is presented of all IRR surgery by a single surgeon from January 1996 to March 2006.

Results: A total of 42 cases were included, with adjustable sutures being used in 40. The mean follow-­up was 9 months. The mean (median) pre-operative vertical deviation in the primary position was 19.8Δ(20Δ) pre-operatively, reducing to 5.2Δ (2Δ) at the final post-operative visit. The aim of a small undercorrection within the patient’s vertical fusion range was achieved in all cases, after adjustment if necessary. By the end of follow-up, 35 (83%) patients retained a satisfactory result, 5 (12%) were over­corrected and 2 (5%) were undercorrected. Twenty-five (60%) remained orthophoric or undercorrected, while 17 (40%) progressed from a planned undercorrection to an overcorrection. Overcorrection was significantly more common in thyroid eye disease (TED) patients (12/20) than the non-TED patients (5/22) (p = 0.014, chi-square). Three patients (7%) demonstrated progressive overcorrection, all of whom had TF.D.

Conclusion: In this study, aiming for a small under­correction within the patient’s vertical fusion range allowed for resolution of symptoms in most cases. TED was more susceptible to overcorrection. Pro­gressive overcorrection did occur, but was uncom­mon.
DOI: https://doi.org/10.22599/bioj.217
How to Cite: Cormack, G. and MacEwen, C., 2007. Inferior rectus recession: outcome of surgery. British and Irish Orthoptic Journal, 4, pp.76–79. DOI: http://doi.org/10.22599/bioj.217
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Published on 01 Jan 2007.
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