Postoperative convergence after recovery from general anesthesia in exotropia surgery

To compare eye position at the end of surgery under general anesthesia with strabismic angles on postoperative day 1 in exotropia surgery.

Seventy-eight patients between 3 and 58 years of age who had undergone surgery were divided into two groups (group A = 46 patients with bilateral rectus recession, group B = 32 patients with surgery that included medial rectus resection). Strabismic angles were measured at the end of surgery under general anesthesia using the Hirschberg test and the alternate prism cover test was performed on postoperative day 1.

Mean strabismic angle was 3.15 prism diopters (PD) under general anesthesia and -6.78 PD on postoperative day 1 in group A and -0.31 and -0.37 PD, respectively, in group B. Mean postoperative convergence was 9.93 PD in group A and 0.06 PD in group B, and the differences were statistically significant (P < .001).

All patients receiving lateral rectus recession showed approximately 10 PD of convergence. Those who received surgery that included medial rectus resection showed much less convergence and a tendency to be the same as at the end of surgery on postoperative day 1.