{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:29:18Z","timestamp":1771547358134,"version":"3.50.1"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2022,2,17]],"date-time":"2022-02-17T00:00:00Z","timestamp":1645056000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Bisa Research Grant of Keimyung University in 2020"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>This retrospective, cross-sectional study investigated changes in corneal lower- and higher-order aberrations that cause visual disturbance after lateral rectus recession and medial rectus resection in children.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Eighty-five eyes of 85 patients (44 boys; 8.64\u00b12.88 years) who underwent lateral rectus recession and medial rectus resection to correct intermittent exotropia were assessed. The Galilei G4 Dual Scheimpflug Analyzer was used for wavefront analysis. Risk factors (age, sex, amount of surgery, preoperative axial length, preoperative intraocular pressure) were determined. Outcome measures included simulated and ray-tracing mode keratometry with secondary defocus, oblique, and vertical astigmatism (for lower-order aberrations) and the root mean square, 3<jats:sup>rd<\/jats:sup>-order vertical and horizontal coma, oblique and horizontal trefoil, 4<jats:sup>th<\/jats:sup>-order spherical aberration, oblique and vertical secondary astigmatism, and oblique and vertical quadrafoil (2<jats:sup>nd<\/jats:sup>\u20128<jats:sup>th<\/jats:sup> sums) (for higher-order aberrations).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Myopic with-the-rule changes in low-order aberrations and increases in simulated and ray-tracing mode keratometry during the 3 months following lateral rectus recession and medial rectus resection were attributed to muscle healing and stability changes. High-order aberrations altered in the week following surgery almost returned to normal within 3 months. Axial length, the amount of surgery, age, and sex affected astigmatism due to differences in patients\u2019 scleral states.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Clinicians should consider changes in high-order aberrations of young individuals who underwent lateral rectus recession and medial rectus resection and may not be able to verbalize changes in vision.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0264037","type":"journal-article","created":{"date-parts":[[2022,2,17]],"date-time":"2022-02-17T18:33:38Z","timestamp":1645122818000},"page":"e0264037","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Alterations of lower- and higher-order aberrations after unilateral horizontal rectus muscle surgery in children with intermittent exotropia: A retrospective cross-sectional study"],"prefix":"10.1371","volume":"17","author":[{"given":"Dong Cheol","family":"Lee","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Se Youp","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9731-1942","authenticated-orcid":true,"given":"Jong Hwa","family":"Jun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,2,17]]},"reference":[{"key":"pone.0264037.ref001","doi-asserted-by":"crossref","first-page":"e000243","DOI":"10.1136\/bmjophth-2018-000243","article-title":"Surgical management of intermittent exotropia: do we have an answer for all?","volume":"4","author":"P Chougule","year":"2019","journal-title":"BMJ Open Ophthalmol"},{"key":"pone.0264037.ref002","first-page":"24","article-title":"Variations of postoperative ocular alignment in patients submitted to strabismus surgery","volume":"74","author":"GS Brum","year":"2011","journal-title":"Arq Bras Oftalmol"},{"key":"pone.0264037.ref003","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1159\/000310599","article-title":"Effects of strabismus surgery on refraction in children","volume":"209","author":"D Denis","year":"1995","journal-title":"Ophthalmologica"},{"key":"pone.0264037.ref004","first-page":"57","article-title":"Postoperative refractive changes in children with congenital esotropia: a preliminary study","volume":"20","author":"M Snir","year":"1989","journal-title":"Ophthal Surg"},{"key":"pone.0264037.ref005","doi-asserted-by":"crossref","first-page":"300","DOI":"10.3928\/0191-3913-19920901-09","article-title":"Refractive error changes following strabismus surgery","volume":"29","author":"MW Preslan","year":"1992","journal-title":"J Pediatr Ophthalmol Strabismus"},{"key":"pone.0264037.ref006","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1007\/s10792-007-9116-z","article-title":"Refractive effect of the horizontal rectus muscle recession","volume":"28","author":"Z Rajavi","year":"2008","journal-title":"Int Ophthalmol"},{"key":"pone.0264037.ref007","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1080\/0065955X.1985.11981664","article-title":"Refractive changes following strabismus surgery","volume":"35","author":"A Fix","year":"1985","journal-title":"Am Orthopt J"},{"key":"pone.0264037.ref008","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1016\/0042-6989(82)90025-6","article-title":"Binocular vision in strabismic humans with alternating fixation","volume":"22","author":"R. 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