Bilateral lateral rectus muscle recession with medial rectus pulley fixation for divergence excess intermittent...

To evaluate the efficacy of bilateral rectus muscle recession with medial rectus pulley posterior fixation for patients with intermittent exotropia with high AC/A ratio.

This study included consecutive patients with exodeviation ≥10(Δ) greater at distance than at near fixation and with a high AC/A ratio who underwent bilateral lateral rectus muscle recession to eliminate the exotropia at distance and pulley posterior suturing on both medial rectus muscles to prevent consecutive esotropia at near fixation. A successful outcome was defined as near or distance angle of exodeviation ≤8(Δ) and a ≤10(Δ) difference between the two.

A total of 7 patients were enrolled. Of these, 5 (71%) achieved successful results. One patient required bifocal correction for postoperative esodeviation at near fixation.

In this case series, most patients with intermittent exotropia and a high AC/A ratio were successfully treated with bilateral lateral rectus muscle recession combined with medial rectus pulley posterior fixation.