Published online Aug 12, 2014. doi: 10.5318/wjo.v4.i3.71
Revised: June 24, 2014
Accepted: July 17, 2014
Published online: August 12, 2014
Core tip: Although numerous operation patterns have been developed for intermittent exotropia with convergence insufficiency, there is not a standard protocol. This paper mainly summarizes three operation patterns including lateral rectus recession(s) with or without a slanting procedure, unilateral lateral rectus recession with medial rectus resection and medial rectus resection(s) with or without a slanting procedure. Merits and demerits of different surgery procedures and the deficiencies of different studies are also elucidated in this paper.
Convergence insufficiency-type intermittent exotropia is defined as a greater exodeviation measured at near than at distance of at least 10 prism diopters. The symptoms of the convergence insufficiency include headaches, asthenopia, difficulty with reading or near tasks and diplopia. In slight cases, symptoms could be alleviated by non-surgical means, such as orthoptic treatment, base-in prism reading glasses, vision therapy and psychotherapy[3,4]. Surgery is reserved for refractory cases that do not respond to these measures or for patients whose deviations are too poorly controlled, or too large at distance or at near to be treatable by nonsurgical means. This review mainly aims to outline the current viewpoints in the surgical interventions to treat convergence insufficiency-type intermittent exotropia. The various surgical treatments for convergence insufficiency-type intermittent exotropia include lateral rectus recession(s) with or without a slanting procedure, unilateral lateral rectus recession with medial rectus resection and medial rectus resection(s) with or without a slanting procedure.