Surgical outcomes in sensory exotropia

To determine success rates over time for strabismus surgery for sensory exotropia and to determine factors associated with successful outcomes.

We retrospectively reviewed medical records of patients with sensory exotropia (best-corrected visual acuity ≤20/200 in the affected eye) who underwent strabismus surgery between May 2009 and December 2019. Patients with paralytic/restrictive exotropia and patients who did not follow up postoperatively were excluded. Surgical success was defined as exotropia of ≤10^Δ or esotropia of ≤6^Δ. Cox-proportional hazard models were used to evaluate covariate relationships with surgical outcome (α = 0.05).

A total of 94 patients (64% female) were included. Mean patient age was 27.2 years (range, 3-69). Mean follow-up was 2.35 ± 2.77 years. The mean preoperative near deviation was 39^Δ ± 14.8^Δ of manifest or intermittent exotropia. Successful alignment was achieved in 51 of 83 patients (61%) at 1 month, 19 of 32 (59%) at 1 year, and 8 of 16 (50%) at 5 years. We found a significant correlation (P value = 0.0476) between success and smaller surgical doses in patients that underwent one- and two-muscle surgeries.

In our study cohort of 94 patients, 50% of patients still had satisfactory ocular alignment at 5 years.