Surgery for Large Angle Exotropia Two Muscles Versus Three Muscles

Study Overview
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Brief Summary
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Comparison Between The Results Of Two Muscles Surgery And Three Muscles Surgery For The Treatment Of Large Angle Exotropia

Detailed Description
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Exotropia is classified as Primary which includes constant and intermittent exotropias. Secondary XT include Sensory and consecutive XT. Management for IXT consists of non-surgical and surgical treatment. There is some controversy regarding the optimal surgical method varying between bilateral lateral rectus recession (BLR), unilateral lateral rectus recession-medial rectus resection (RR) and bilateral medial rectus resection (BMR).

Official Title
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Comparison Between The Results Of Operating Two Muscles And Operating Three Muscles For The Treatment Of Large Angle Exotropia

Conditions
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Exotropia

Intervention / Treatment
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* Procedure: surgery


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients above age of 5 years with concomitant Exotropia of (40-55) PD of any type. Exclusion Criteria: Angle of deviation less than 40 PD or more than 55 PD. History of previous surgery. Inconcomitant exotropia. Incomitance in any gaze. Associated vertical deviation(oblique dysfunction,A or V pattern). Patients with neurological deficit.

Ages Eligible for Study
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Minimum Age: 5 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: 69 Patients with exotropia of (40-55) PD who are ≥ 5 years old. The 1st group will do two muscles surgery; bilateral lateral rectus recession. The 2nd group will do three muscles surgery; bilateral lateral rectus recession and unilateral medial rectus tucking.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: group 1 :Two muscle surgery<br>30 patients will underwent two muscle surgery(bilateral lateral rectus muscle recession) | Procedure: surgery<br>* 69 Patients with exotropia of (40-55) PD who are ≥ 5 years old. The 1st group 30 patients had two muscles surgery; bilateral lateral rectus recession. The 2nd group 39 patients had three muscles surgery; bilateral lateral rectus recession and unilateral medial rectus tucking.<br>|
| Active Comparator: group 2:Three muscle surgery<br>39 patients underwent three muscle surgery(bilateral lateral rectus muscle recession with unilateral medial rectus muscle tucking) | Procedure: surgery<br>* 69 Patients with exotropia of (40-55) PD who are ≥ 5 years old. The 1st group 30 patients had two muscles surgery; bilateral lateral rectus recession. The 2nd group 39 patients had three muscles surgery; bilateral lateral rectus recession and unilateral medial rectus tucking.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| alignment in the primary position | measuring any misalignment by prism bar | 1 week to 6 months | 
| palpebral fissure height | measuring with millimeter | 1 week to 6 months | 
| End gaze deficit | measuring with prism bar | 1 week to 6 months |