Augmented surgical amounts for intermittent exotropia to prevent recurrence

Area of Science:

• Ophthalmology
• Strabismus Surgery
• Pediatric Ophthalmology

Background:

• Intermittent exotropia [X(T)] is a common condition requiring surgical intervention.
• Current surgical techniques for X(T] aim to realign eye muscles, but recurrence and overcorrection can occur.

Purpose of the Study:

• To evaluate the efficacy of bilateral lateral rectus (BLR) recession using augmented surgical amounts for basic and pseudo-divergence excess type intermittent exotropia [X(T)].
• To assess the motor surgical outcomes and success rates of this modified surgical approach.

Main Methods:

• A retrospective study included 37 patients with X(T) who underwent BLR surgery with augmented recession amounts.
• Surgical recession was increased by 5 prism diopters (PD) more than the measured deviation.
• Patients were grouped based on 1-week postoperative alignment, and outcomes were classified as 'good', 'recurrence', or 'overcorrected' at 6 months.

Main Results:

• The mean preoperative deviation was 29.72 PD at distance and 20.94 PD at near.
• Initial esotropia was achieved in 30 patients (81.1%).
• At 6 months, 28 patients (75.7%) had 'good' outcomes, with an overall motor surgical success rate of 89.2% (33/37 patients).

Conclusions:

• Augmented bilateral lateral rectus recession, intentionally overcorrecting by 10-20 PD, can achieve acceptable motor outcomes in the initial 6 months post-surgery for intermittent exotropia [X(T)].
• This approach demonstrates a high success rate with low rates of recurrence and overcorrection.