Long-term outcome of patients with large overcorrection following surgery for exotropia

To provide long-term surgical results for patients with large initial overcorrection following surgery for exodeviation, 68 consecutive patients with initial overcorrection of 20 prism diopters (PD) or more at distance or near following surgery for exodeviation performed between 1994 and 2002 were included in this study. The patients were managed with an alternate full-time occlusion, echothiophate iodide, or prism glasses for the period of overcorrection. One day postoperatively, the amount of overcorrection was 8--40 PD at distance and 0--35 PD at near, and decreased to 10 PD or less both at distance and near vision within 4 weeks postoperatively in 49 patients (72%). Seven patients needed prism glasses for esotropia of less than 10 PD. Four patients (5.9%) needed a reoperation for consecutive esotropia and 1 patient for postoperative hypotropia following recession of the superior and lateral rectus. The final outcome showed orthophoria to exo/esodeviation of 10 PD in 11 patients (16%) at near or distance. In conclusion, overcorrection was reduced to 10 PD or less at distance and near within 4 weeks after surgery in most patients. Even with initial overcorrection of 20 PD or more after surgery for exodeviation, reoperation for consecutive esotropia was necessary only in 5.9% of the patients.