{
  "abstract": "Purpose\n\nThis study aimed to evaluate a novel surgical approach combining unilateral lateral rectus recession (LRc) with compartmentalized inferior medial rectus plication (CIMRP) for treating small-angle (< 25 prism diopters, PD) convergence insufficiency intermittent exotropia (CI-IXT) in pediatric patients.Methods\n\nA retrospective analysis was conducted on 69 pediatric CI-IXT patients (mean age: 8.13 ± 2.46 years; range: 4-14 years) who underwent unilateral LRc and CIMRP between September 2022 and January 2024 at Tianjin Eye Hospital. All patients completed a minimum 12-month follow-up (mean: 12.41 ± 1.42 months; range: 12-18 months). Outcomes including near and distance deviations, near-distance difference (NDD), control scores, stereopsis, and complications were assessed preoperatively and postoperatively at 1 day, 2 months, 6 months, and final follow-up (12-18 months). Surgical success was defined as an exodeviation ≤ 10 PD or esodeviation ≤ + 5 PD in primary gaze at distance and near, and NDD ≤ 8 PD.Results\n\nThe mean LRc amount was 7.08 ± 0.48 mm (range: 6.5-7.5 mm), and the mean CIMRP amount was 3.56 ± 0.39 mm (range: 3.0-4.0 mm). Significant reductions were observed in near exo-deviation (median: -30 [- 32, - 28] PD to - 12 [- 16, - 6] PD), distance deviation (- 20 [- 20, - 18] PD to - 6 [- 10, - 1] PD), and NDD (10 [10, 10] PD to 4 [4, 6] PD; all P < 0.001, Friedman test).Simple linear regression identified an exploratory association between CIMRP amount and corrected NDD (defined as preoperative NDD minus postoperative NDD): Corrected NDD = 5.973 × CIMRP (mm) - 12.48 (P < 0.0001, R² = 0.2042). This indicates that each 1 mm increase in plication amount was associated with an average increase of approximately 5.97 PD in NDD correction within the observed 3.0-4.0 mm range. Surgical success was achieved in 88.41% at both 2 and 6 months, decreasing slightly to 81.16% at the final follow-up. The overcorrection rate peaked at 8.7% at 2 months and subsequently stabilized at 2.9%, whereas the undercorrection rate gradually increased to 15.9%. Control scores and near stereoacuity improved significantly after surgery (P < 0.001 and P < 0.05, respectively).Conclusion\n\nUnilateral LRc combined with CIMRP is an effective and safe approach for small angle CI-IXT (< 25 PD). Based on preliminary evidence from this exploratory analysis, we tentatively suggest CIMRP of ≥ 3.5 mm for preoperative NDD > 10 PD, pending prospective validation. While this targeted technique addresses convergence insufficiency with favorable outcomes, further comparative studies are needed to define its clinical role.",
  "abstract_shown": true,
  "affiliations": [
    "Tianjin Eye Hospital, 300020, Tianjin, China.",
    "Tianjin Key Lab of Ophthalmology and Visual Science, 300020, Tianjin, China.",
    "Tianjin Eye Hospital, 300020, Tianjin, China. leeyueping@aliyun.com.",
    "Tianjin Key Lab of Ophthalmology and Visual Science, 300020, Tianjin, China. leeyueping@aliyun.com."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Juan Ding"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Pin Zhu"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Liping Chen"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Rui Hao"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Wei Zhang"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Yueping Li"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/42y7pz530z1nv.bib",
  "cited_by": 0,
  "doi": "10.1186/s12886-026-05164-2",
  "fulltext_url": "https://europepmc.org/articles/PMC13721381",
  "id": "42y7pz530z1nv",
  "issns": [
    "1471-2415"
  ],
  "landing_url": "https://europepmc.org/article/MED/42958107",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "2734|Ophthalmology and Eye Disorders"
    ]
  ],
  "openalex": "W7172266404",
  "pdf_url": "https://europepmc.org/articles/PMC13721381?pdf=render",
  "pmcid": "PMC13721381",
  "pmid": "42958107",
  "published": "2026-08-03",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/42y7pz530z1nv.ris",
  "sources": [
    {
      "first_seen": "2026-11-01T00:20:47Z",
      "native_id": "MED:42958107",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42958107"
    },
    {
      "first_seen": "2026-11-03T12:22:05Z",
      "native_id": "PMC13721381",
      "source": "pmc",
      "url": "https://doi.org/10.1186/s12886-026-05164-2"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2734|Ophthalmology and Eye Disorders",
      "subfield": "general"
    }
  ],
  "title": "Selective compartmental plication in small-angle convergence insufficiency exotropia: surgical outcomes and predictive model.",
  "title_text": "Selective compartmental plication in small-angle convergence insufficiency exotropia: surgical outcomes and predictive model.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-03T12:22:05Z",
  "url": "https://research.draconitic.com/paper/42y7pz530z1nv",
  "venue": "BMC ophthalmology",
  "versions": []
}