Outcomes of surgery in patients with sensory exotropia

Sensory exotropia is often due to profound amblyopia. Surgery essentially aims to improve aesthetic appearance and quality of life. Our goal was to discuss clinical features of sensory exotropia as well as surgical indications and outcomes.

Medical records of 43 patients who underwent sensory exotropia surgery were retrospectively reviewed. Each patient had an ophthalmological examination and a complete sensorimotor assessment. All surgeries were performed by the same surgeon. We studied the influence of certain prognostic factors on motility outcomes, such as age of onset of strabismus, gender, delay of surgical management, degree of amblyopia, angle of deviation, and amount of recession/resection.

The mean follow-up was 2.3 years. All of our patients had severe amblyopia. An abnormal retinal correspondence with no fusion or stereopsis was noted in all subjects. The mean angle of deviation was 44.5 PD±12.4 SD preoperatively. The alignment success rate after a single procedure was 65.1%. Eight patients developed recurrent exotropia and were reoperated, with a final alignment success rate of 74.4%.

Sensory exotropia is characterized by a large angle of deviation and an altered sensory status. The overall goal of surgery is to improve the patient's aesthetics and quality of life by treating the maximum angle of deviation. Surgical outcomes are often satisfactory for the patients, but certain complications may occur, such as diplopia, enopthalmos, and recurrences.