Is single-stage two-muscle surgery of 7-11 mm enough for large-angle exotropia?

Area of Science:

• Ophthalmology
• Strabismus Surgery
• Pediatric Ophthalmology

Background:

• Large-angle exotropia presents a significant challenge in strabismus management.
• Surgical correction aims to restore binocular alignment and improve visual function.
• The choice of surgical technique impacts outcomes and potential complications.

Purpose of the Study:

• To evaluate the effectiveness of a single-stage, two-muscle surgical procedure for large-angle exotropia.
• To assess the success rate and safety of this approach in patients with significant exodeviation.

Main Methods:

• Retrospective analysis of 34 patients with large-angle comitant exodeviation.
• Patients categorized into severe (≥50 PD) and moderate (30-49 PD) deviation groups.
• Successful outcome defined as alignment within 12 PD of orthophoria/tropia.

Main Results:

• Overall success rate of 71% (25/34 patients) in achieving successful alignment.
• Higher success rate in moderate exotropia (81%) versus severe (67%), though not statistically significant.
• No permanent diplopia reported; minimal abduction deficits in two patients.

Conclusions:

• Two-muscle surgery is a viable and effective option for correcting large-angle exodeviations.
• This surgical approach avoids significant abduction deficits and preserves horizontal rectus muscles.
• The procedure offers a favorable risk-benefit profile for managing complex exotropia.