Bilateral Lateral Rectus Recession Versus Unilateral Recess-Resect for Intermittent Exotropia (IXT1)

This study is ongoing, but not recruiting participants.
Information provided by (Responsible Party):
Jaeb Center for Health Research Identifier:
First received: December 11, 2009
Last updated: December 18, 2014
Last verified: December 2014

The purpose of this study is to evaluate the effectiveness of bilateral lateral rectus muscle recession versus unilateral lateral rectus recession with medial rectus resection procedures for the treatment of basic type and pseudo divergence excess type intermittent exotropia.

Condition Intervention
Procedure: Bilateral lateral rectus recession (BLRrec)
Procedure: Unilateral lateral rectus recession with medial rectus resection (R&R)

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Randomized Trial of Bilateral Lateral Rectus Recession Versus Unilateral Lateral Rectus Recession With Medial Rectus Resection for Intermittent Exotropia

Resource links provided by NLM:

Further study details as provided by Jaeb Center for Health Research:

Primary Outcome Measures:
  • surgical failure as assessed by motor alignment and stereoacuity at near [ Time Frame: 3 years ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • distance stereoacuity [ Time Frame: every 6 months for 3 years of follow-up ] [ Designated as safety issue: No ]
  • monofixation status [ Time Frame: every 6 months for 3 years of follow-up ] [ Designated as safety issue: No ]
  • development of amblyopia [ Time Frame: every 6 months for 3 years of follow-up ] [ Designated as safety issue: No ]
  • health related quality of life [ Time Frame: every 6 months for 3 years of follow-up ] [ Designated as safety issue: No ]

Estimated Enrollment: 336
Study Start Date: June 2010
Estimated Study Completion Date: December 2016
Estimated Primary Completion Date: December 2016 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: Bilateral lateral rectus recession Procedure: Bilateral lateral rectus recession (BLRrec)
Bilateral lateral rectus recession surgery
Other Names:
  • BLR
  • BLRrec
Active Comparator: Unilateral lateral rectus recession w/ medial rectus resection Procedure: Unilateral lateral rectus recession with medial rectus resection (R&R)
A unilateral lateral rectus recession combined with a medial rectus resection in the same eye. Choice of eye at investigator discretion based on any interocular difference, position under anesthesia, fixation preference, or forced duction testing. Reason for choice of eye will be recorded.
Other Name: R&R

  Show Detailed Description


Ages Eligible for Study:   3 Years to 10 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Age 3 to < 11 years
  • Intermittent exotropia (manifest deviation) meeting all of the following:

    • Intermittent exotropia at distance OR constant exotropia at distance and either intermittent exotropia or exophoria at near
    • Largest exodeviation at either distance, near OR remote distance between 15 and 50 PD (inclusive) by prism and alternate cover test (PACT)
    • Exodeviation at least 15 PD at distance and near by PACT
    • Basic type or pseudo divergence excess type
  • Stereoacuity of 400 arcsec or better at near by Preschool Randot stereotest (better of 2 measures)
  • Visual acuity in the worse eye at least 0.3 logMAR (20/40 on ATS HOTV or 70 letters on E-ETDRS)
  • No interocular difference of visual acuity more than 0.2 logMAR (2 lines on ATS HOTV or 10 letters on E-ETDRS testing)
  • Absence of high AC/A ratio (exclude > 6:1)
  • No previous intraocular surgery, strabismus surgery, or botulinum toxin treatment
  • Investigator planning to perform surgery for correction of IXT
  • No hyperopia greater than +3.50 D spherical equivalent (SE) in either eye

Exclusion Criteria:

  • Coexisting vertical deviation, oblique muscle dysfunction, DVD, or A or V pattern, any of which the investigator plans to address with vertical transposition of horizontal rectus muscles, oblique surgery, or vertical rectus muscle surgery, i.e., only small vertical deviations, oblique muscle dysfunction, DVD, and A or V patterns not requiring surgery are allowed
  • Limitation of ocular rotations due to restrictive or paretic strabismus
  • Craniofacial malformations affecting the orbits
  • Interocular visual acuity difference of more than 0.2 logMAR (2 lines on ATS HOTV for patients 3 to < 7 years old or 10 letters on E-ETDRS for patients ≥ 7 years old) and/or investigator plans to initiate amblyopia treatment at this time.
  • High AC/A ratio (exclude > 6:1 by gradient method)
  • Prior strabismus surgery or botulinum toxin injection
  • Ocular disorders that would reduce visual acuity (except refractive error)
  • Prior intraocular or refractive surgery
  • Significant neurological impairment such as cerebral palsy. Patients with mild speech and/or learning disabilities are eligible.
  • Investigator planning to change refractive correction at this time (if the patient is otherwise eligible, the investigator should consider prescribing refractive correction and bringing the patient back at a later time for enrollment).
  Contacts and Locations
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Please refer to this study by its identifier: NCT01032603

United States, Tennessee
Vanderbilt Children's Hospital
Nashville, Tennessee, United States, 37232-8808
Sponsors and Collaborators
Jaeb Center for Health Research
Study Chair: Sean P Donahue, M.D., Ph.D. Pediatric Ophthalmology Service, Vanderbilt Children's Hospital, Nashville, TN
  More Information

No publications provided

Responsible Party: Jaeb Center for Health Research Identifier: NCT01032603     History of Changes
Other Study ID Numbers: NEI-145, 2U10EY011751
Study First Received: December 11, 2009
Last Updated: December 18, 2014
Health Authority: United States: Federal Government

Keywords provided by Jaeb Center for Health Research:
Intermittent exotropia

Additional relevant MeSH terms:
Cranial Nerve Diseases
Eye Diseases
Nervous System Diseases
Ocular Motility Disorders
Strabismus processed this record on May 21, 2015