{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T14:23:01Z","timestamp":1791469381062,"version":"4.3.4"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T00:00:00Z","timestamp":1751241600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the impact of high myopia on the surgical dose\u2013response in unilateral recession and resection (R&amp;amp;R) surgery for exotropia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis was conducted on 101 Chinese patients who underwent unilateral R&amp;amp;R surgery for concomitant exotropia between June 2021 and June 2024. Patients were divided into two groups based on axial length: those with high myopia (<jats:italic>n<\/jats:italic> =\u202f38) and those without high myopia (<jats:italic>n<\/jats:italic> =\u202f63). Surgical doses for lateral rectus (LR) recession and medial rectus (MR) resection were compared between the groups. Preoperative and postoperative deviations were measured, and statistical analyses were performed to assess the relationship between surgical dose, axial length (AL), and other clinical variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Age, duration of exotropia, and AL differed significantly between the groups, but other baseline characteristics were comparable. The LR recession dose did not differ significantly between the high myopia group (6.40\u202f\u00b1\u202f1.11\u202fmm) and the non-high myopia group (6.74\u202f\u00b1\u202f1.00\u202fmm, <jats:italic>p<\/jats:italic>\u202f&amp;gt;\u202f0.05). However, the MR resection dose was significantly lower in the high myopia group (5.77\u202f\u00b1\u202f1.02\u202fmm) compared to the non-high myopia group (6.32\u202f\u00b1\u202f0.92\u202fmm, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05). The MR resection and LR recession dose was positively correlated with the horizontal deviation (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001), but showed no significant correlation with AL (<jats:italic>p<\/jats:italic>\u202f&amp;gt;\u202f0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Exotropia with high myopia had a greater surgical dose response than those without high myopia. No significant difference was found in LR recession dose, but the MR resection dose was significantly lower in the high myopia group.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1588698","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T05:26:28Z","timestamp":1751261188000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["The influence of high myopia-related exotropia on surgical dose\u2013response in unilateral recession and resection surgery: a retrospective study"],"prefix":"10.3389","volume":"12","author":[{"given":"Chao","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ZhiYin","family":"Lou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,6,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1016\/j.ophtha.2004.07.033","article-title":"Incidence and types of childhood exotropia: a population-based study","volume":"112","author":"Govindan","year":"2005","journal-title":"Ophthalmology"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"854","DOI":"10.1136\/bjo.86.8.854","article-title":"Changing patterns of strabismus: a decade of experience in Hong Kong","volume":"86","author":"Yu","year":"2002","journal-title":"Br J Ophthalmol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1051","DOI":"10.1016\/j.survophthal.2021.03.005","article-title":"The impact of strabismus on psychosocial heath and quality of life: a systematic review","volume":"66","author":"Buffenn","year":"2021","journal-title":"Surv Ophthalmol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1085","DOI":"10.1016\/j.ajo.2006.06.053","article-title":"Factors associated with a previous diagnosis of strabismus in a population-based sample of 12-year-old Australian children","volume":"142","author":"Robaei","year":"2006","journal-title":"Am J Ophthalmol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"2251","DOI":"10.1016\/j.ophtha.2011.06.032","article-title":"Risk factors associated with childhood strabismus","volume":"118","author":"Cotter","year":"2011","journal-title":"Ophthalmology"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1038\/srep35177","article-title":"Refractive errors and concomitant strabismus: a systematic review and Meta-analysis","volume":"6","author":"Tang","year":"2016","journal-title":"Sci Rep"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1248","DOI":"10.1111\/opo.13366","article-title":"High myopia: reviews of myopia control strategies and myopia complications","volume":"44","author":"Shah","year":"2024","journal-title":"Ophthalmic Physiol Opt"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"P179","DOI":"10.1016\/j.ophtha.2022.11.002","article-title":"Esotropia and exotropia preferred practice pattern\u00ae","volume":"130","author":"Sprunger","year":"2023","journal-title":"Ophthalmology"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1007\/s00417-018-3912-1","article-title":"Bilateral lateral rectus recession versus unilateral recession resection for basic intermittent exotropia: a meta-analysis","volume":"256","author":"Sun","year":"2018","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1616","DOI":"10.1001\/archopht.1989.01070020694030","article-title":"The influence of axial length on the response to strabismus surgery","volume":"107","author":"Kushner","year":"1997","journal-title":"Arch Ophthalmol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1319","DOI":"10.1007\/s00417-020-04690-z","article-title":"Consideration of eyeball length and prismatic side-effects of spectacle lenses in strabismus surgery\u2014a randomised, double-blind interventional study","volume":"258","author":"Beisse","year":"2020","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1016\/j.ajo.2025.03.024","article-title":"Posterior eye curvature as a biomarker for differentiating pathologic myopia from high myopia","volume":"275","author":"Chen","year":"2025","journal-title":"Am J Ophthalmol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"e0198002","DOI":"10.1371\/journal.pone.0198002","article-title":"Effect of combining inferior oblique muscle weakening procedures with exotropia surgery on the surgical correction of exotropia","volume":"13","author":"Awadein","year":"2018","journal-title":"PLoS One"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1016\/j.joco.2019.02.001","article-title":"The effect of inferior oblique muscle weakening on horizontal alignment","volume":"31","author":"Rajavi","year":"2019","journal-title":"J Curr Ophthalmol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1120","DOI":"10.18240\/ijo.2017.07.16","article-title":"Factors affecting residual exotropia after two muscle surgery for intermittent exotropia","volume":"10","author":"Tibrewal","year":"2017","journal-title":"Int J Ophthalmol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"6484","DOI":"10.1038\/s41598-021-86004-9","article-title":"Clinical factors affecting the rate of exodrift after surgery in patients with basic intermittent exotropia","volume":"11","author":"Kim","year":"2021","journal-title":"Sci Rep"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1016\/j.jfma.2024.03.023","article-title":"Revisiting the surgical table: an analysis of surgical dose-response in Asian exotropia","volume":"124","author":"Lai","year":"2024","journal-title":"J Formos Med Assoc"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1038\/eye.2014.29","article-title":"Intermittent exotropia: relation between age and surgical outcome: a change-point analysis","volume":"28","author":"Awadein","year":"2014","journal-title":"Eye"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1038\/eye.1996.66","article-title":"Factors influencing the successful outcome and response in strabismus surgery","volume":"10","author":"Abbasoglu","year":"1996","journal-title":"Eye"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1485","DOI":"10.1007\/s00417-012-1991-y","article-title":"Factors predisposing to consecutive esotropia after surgery to correct intermittent exotropia","volume":"250","author":"Jang","year":"2012","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1055\/a-2511-3537","article-title":"Does axial length influence the dose effect of horizontal strabismus surgery?","volume":"242","author":"Uecelehan","year":"2025","journal-title":"Klin Monatsbl Augenheilkd"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1300","DOI":"10.1111\/opo.12890","article-title":"Do rectus muscle parameters vary between emmetropes and myopes?","volume":"41","author":"Vasudeva","year":"2021","journal-title":"Ophthalmic Physiol Opt"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1588698\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T05:26:29Z","timestamp":1751261189000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1588698\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,30]]},"references-count":22,"alternative-id":["10.3389\/fmed.2025.1588698"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1588698","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,30]]},"article-number":"1588698"}}