Combined recession and resection of the same lateral Rectus in the treatment of exotropia.

BACKGROUND: Besides rest position abnormalities, exotropia could also be due to hypertonia of the Lateral Recti (LR) given divergence frequently decreases under general anesthesia (GA). Combined Recession-Resection of the Same Muscle (RRSM) is a promising alternative to the Faden procedure in the surgical treatment of overacting MR in esotropia. We thus examined here the effectiveness of combined RRSM of the LR for the treatment of exotropia that decrease under GA. METHODS: We performed a retrospective, single-center evaluation over a 16-month period of 100 patients operated on for exotropia that decreased under deep GA (91% of 110 consecutive operated cases). We excluded re-operations and pure convergence insufficiencies. We performed a combined RRSM of one or two LR. It included a 10mm-recession and a "fine-tuned" resection of LR based on Quantitative Forced Duction Test scores. MR resection was combined when exotropia exceeded 35PD or for unilateral surgery. We report on patient outcomes 6 months after surgery. RESULTS: Successful results were obtained (-8-+8 PD measured on Alternate Cover Test) among 83% of cases at distance fixation and 91% at near fixation after 6 months. The Newcastle Control Score also improved from 5.8 to 1.7 after 6 months. No surgery-related complications or repeat surgeries were reported. CONCLUSIONS: In our experience a majority of exotropias decrease under GA and our strategy of combined RRSM of the LR is effective for the treatment of such exotropias. Long-term follow-up of the cohort is required to investigate the stability of these outcomes, and confirmation of our results by other works.

[Visual screening in infancy: recommendation's update in France]. / Dépistage de l'amblyopie en France.

Visual screening in infancy in france. Prevalence of amblyopia is 3 to 5% of the French population. Early recognition and screening allows to treat it effectively. Ophthalmic emergency clinical signs will be sought during pediatric consultations. Risk factors for organic or functional ophthalmological pathologies will be identifies by the pediatrician or the general practitioner. They will guide an ophthalmological consultation in the first month of life or between 12 and 15 months.Children without clinical signs or risk factors should have a systematic orthoptic examination in the third year, including visual acuity measurement, cover-test avec refractive screening by photo- screener.

Dépistage de l'amblyopie en france. L'amblyopie touche 3 à 5 % de la population française. Son dépistage ou celui de ses facteurs de risque doit être précoce afin de la traiter de façon efficace. Lors des examens cliniques pédiatriques, les signes cliniques d'urgence ophtalmologique sont recherchés à tout âge. Les facteurs de risque de pathologies organiques ou fonctionnelles ophtalmologiques peuvent être identifiés par le pédiatre ou le médecin traitant. Ils guident une consultation ophtalmologique dans le premier mois de vie pour les premiers et entre 12 et 15 mois pour les seconds. Les enfants n'ayant ni signe clinique ni facteur de risque doivent bénéficier d'un examen orthoptique systématique lors de la troisième année, incluant la mesure de l'acuité visuelle, un test de l'écran et un dépistage réfractif par photoscreener.