Evidence map›Paper›PMID 40812444›Full record

ArticleAmerican journal of ophthalmology2025

Surgical Dosing for V-Pattern Exotropia.

Veronika Yehezkeli, Emanuil Parunakian, Soh Youn Suh, Qingyu Meng, Joseph L Demer

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of ophthalmology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Veronika YehezkeliFrom the Stein Eye Institute and Department of Ophthalmology (V.Y., S.Y.S., Q.M., J.L.D.), University of California, Los Angeles, Los Angeles, California, USA.
Emanuil ParunakianDavid Geffen School of Medicine at University of California, Los Angeles (E.P., S.Y.S., J.L.D.), Los Angeles, California, USA.
Soh Youn SuhFrom the Stein Eye Institute and Department of Ophthalmology (V.Y., S.Y.S., Q.M., J.L.D.), University of California, Los Angeles, Los Angeles, California, USA; David Geffen School of Medicine at University of California, Los Angeles (E.P., S.Y.S., J.L.D.), Los Angeles, California, USA.
Qingyu MengFrom the Stein Eye Institute and Department of Ophthalmology (V.Y., S.Y.S., Q.M., J.L.D.), University of California, Los Angeles, Los Angeles, California, USA; Department of Ophthalmology (Q.M.), Peking University People's Hospital, Beijing, China.
Joseph L DemerFrom the Stein Eye Institute and Department of Ophthalmology (V.Y., S.Y.S., Q.M., J.L.D.), University of California, Los Angeles, Los Angeles, California, USA; David Geffen School of Medicine at University of California, Los Angeles (E.P., S.Y.S., J.L.D.), Los Angeles, California, USA; Department of Neurology (J.L.D.), University of California, Los Angeles, Los Angeles, California, USA; Bioengineering Department (J.L.D.), University of California, Los Angeles, Los Angeles, California, USA; Neuroscience Interdepartmental Program (J.L.D.), University of California, Los Angeles, Los Angeles, California, USA. Electronic address: jld@jsei.ucla.edu.

Funding

Vision Research Core at UCLAP30EY000331 · NEI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Xian-Jie Yang · 1985 to 2026
$16.8M
BIOMECHANICAL ANALYSIS IN STRABISMUS SURGERYR01EY008313 · NEI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI JOSEPH Louis DEMER · 1991 to 2026
$15.0M
NEI NIH HHS P30 EY000331NEI NIH HHS R01 EY008313
6 · The paper itself

Abstract

purposeConsensus is lacking around optimal surgical strategies to correct V-pattern exotropia (VXT). This study quantitatively examined alternative surgical strategies and dosing .

designComparative interventional case series.

methodsConsecutive patients with VXT undergoing strabismus surgery between 2014 and 2025 were reviewed. Incomitance of at least 15D between sursumversion and deorsumversion was considered V-pattern. Surgeries were performed by 2 surgeons using identical technique. The primary outcome was the surgical alignment effect.

resultsA total of 55 patients (36 children and 19 adults) underwent horizontal rectus muscle surgery: inferior oblique (IO) recession (n = 12), superior transposition of lateral rectus muscles (n = 20), their combination (n = 10), and no modifications (n = 13). Surgery reduced average primary gaze exotropia in all groups from 29 ± 11Δ to 8 ± 8Δ (SD P < .001), irrespective of pattern collapse. There was 6.0 Δ mean postoperative exodrift after 2.1 ± 2.0 years following surgery. Pattern decreased in all groups from: 22 ± 8Δ to 10 ± 8Δ by IO recession, 22 ± 6Δ to 3 ± 6Δ by horizontal rectus transposition, 30 ± 10Δ to 5 ± 13Δ by the combination, and 16 ± 2Δ to 6 ± 7Δ with no modifications. The combined procedure yielded the greatest pattern reduction. Transpositions of half and three-quarter tendon width yielded similar effects on pattern. Linear regression showed a significant correlation between lateral rectus recession and exotropia reduction (P < .001), accounting for 40% of variance. However, the surgical effect was smaller than that predicted by Parks tables.

conclusionsIO recession, LR transposition, and their combination reduce pattern in VXT, with the greatest effect when combined. Horizontal rectus recession alone also reduces the pattern, albeit to a lesser extent. Horizontal rectus recession dose need not be adjusted for pattern collapse. Early overcorrection is recommended.

Indexed as

ExotropiaEye MovementsOculomotor MusclesOphthalmologic Surgical ProceduresVision, BinocularAdolescentAdultChildChild, PreschoolFemaleFollow-Up StudiesHumansMaleMiddle AgedRetrospective StudiesTreatment Outcome

Identifiers

PMID40812444
PMCPMC13046288

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.