Efficacy of bilateral lateral rectus recession versus unilateral recession and resection for basic-type intermittent exotropia: a meta-analysis

Abstract

Purpose: To investigate the efficacy of bilateral lateral rectus recession (BLR) versus unilateral recession and resection (RR) for the treatment of patients with basic-type intermittent exotropia (IXT). Methods: We systematically searched the EMBASE, PubMed, Web of Science and Cochrane Library databases for relevant studies published before April 2020 with no language restrictions. Related studies meeting the eligibility criteria were included. The primary outcomes were success rate and mean postoperative deviation. Odds ratios (ORs) and weighted mean differences (MDs) with 95% confidence intervals (CIs) were calculated. Results: From 1243 screened articles, a total of 10 studies involving 967 patients were included in the analysis. No differences were observed in success rates between the BLR and RR groups at 1-day to 1-week postoperatively (OR: 0.9, 95% CI: 0.53 to 1.53, p = 0.69), or at 6-month postoperatively (OR: 1.11, 95% CI: 0.59 to 2.11, p = 0.74), or at the last follow-up visit (OR: 0.76, 95% CI: 0.44 to 1.34, p = 0.34). The unsatisfactory effects (the overcorrection and undercorrection rates) between the two groups were comparable. In addition, there were no significant differences between the two groups in postoperative deviation at 1-day to 1-week postoperatively (MD: 0.03, 95% CI: −1.32 to 1.27, p = 0.97), or at 6-month postoperatively (MD: 1.42, 95% CI: −0.43 to 3.27, p = 0.13) or at the last follow-up visit (MD: 0.29, 95% CI: −1.39 to 1.97, p = 0.74). Conclusion: This meta-analysis provides evidence that both the BLR and RR procedures have similar efficacy for the treatment of basic-type IXT.