Recurrence of Intermittent Exotropia after Bilateral Lateral Rectus Recession

Middle East Afr J Ophthalmol. 2020 Jul 20;27(2):123-127. doi: 10.4103/meajo.MEAJO_188_18. eCollection 2020 Apr-Jun.

Abstract

Purpose: The purpose of this study was to evaluate predictive factors for intermittent exotropia (XT) recurrence after bilateral lateral rectus (BLR) recession.

Methods: This is a retrospective chart review of patients with XT who underwent BLR recession surgery between January 2007 and March 2017 with at least one postsurgical follow-up. Forty-one medical records were reviewed. Information collected included age, gender, systemic diseases, history of prematurity, family history of eye diseases, visual acuity, refraction, ocular alignment and control, stereoacuity, slit-lamp examination, fundoscopy, and amount of BLR recession. Successful alignment was defined as ≤8 prism diopters of esotropia or exotropia postoperatively.

Results: The mean age of patients at the time of surgery and follow-up time was 9.2 ± 12.3 years (y) and 23.6 ± 36.5 months (m), respectively. The mean amount of BLR recession was 6.5 ± 1.0 mm. Recurrence rate was 43.9% on the last follow-up. Age at surgery and at the time of last follow-up were significantly higher in the recurring group (P = 0.04 and P = 0.05, respectively). Postoperative angle of misalignment during the first 3 months was correlated with exotropia recurrence. No statistical significance was found among the remaining factors studied.

Conclusions: The recurrence rate of XT in our study was 43.9%; it was increased in patients operated at older age and amid those with significant exotropia detected in the early postoperative period (within 3 months of surgery).

Keywords: Bilateral lateral rectus recession; intermittent exotropia; strabismus; surgery.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Chronic Disease
  • Exotropia / diagnosis*
  • Exotropia / physiopathology
  • Exotropia / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Oculomotor Muscles / surgery*
  • Ophthalmologic Surgical Procedures*
  • Ophthalmoscopy
  • Postoperative Period
  • Recurrence
  • Refraction, Ocular
  • Retrospective Studies
  • Slit Lamp Microscopy
  • Treatment Outcome
  • Vision, Binocular / physiology
  • Visual Acuity / physiology
  • Young Adult