Surgical outcomes in sensory exotropia

J AAPOS. 2023 Jun;27(3):147.e1-147.e5. doi: 10.1016/j.jaapos.2023.04.005. Epub 2023 May 13.


Purpose: To determine success rates over time for strabismus surgery for sensory exotropia and to determine factors associated with successful outcomes.

Methods: We retrospectively reviewed medical records of patients with sensory exotropia (best-corrected visual acuity ≤20/200 in the affected eye) who underwent strabismus surgery between May 2009 and December 2019. Patients with paralytic/restrictive exotropia and patients who did not follow up postoperatively were excluded. Surgical success was defined as exotropia of ≤10Δ or esotropia of ≤6Δ. Cox-proportional hazard models were used to evaluate covariate relationships with surgical outcome (α = 0.05).

Results: A total of 94 patients (64% female) were included. Mean patient age was 27.2 years (range, 3-69). Mean follow-up was 2.35 ± 2.77 years. The mean preoperative near deviation was 39Δ ± 14.8Δ of manifest or intermittent exotropia. Successful alignment was achieved in 51 of 83 patients (61%) at 1 month, 19 of 32 (59%) at 1 year, and 8 of 16 (50%) at 5 years. We found a significant correlation (P value = 0.0476) between success and smaller surgical doses in patients that underwent one- and two-muscle surgeries.

Conclusions: In our study cohort of 94 patients, 50% of patients still had satisfactory ocular alignment at 5 years.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Exotropia* / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Oculomotor Muscles / surgery
  • Ophthalmologic Surgical Procedures
  • Retrospective Studies
  • Treatment Outcome
  • Vision, Binocular / physiology
  • Young Adult