[Paying attention to problems and countermeasures in intermittent exotropia surgery]

Intermittent exotropia (IXT) is the most common type of strabismus, with surgical interventions standing as its main therapeutic modality. In recent years, with the rapid development of the strabismus and pediatric ophthalmology subspecialties, surgical correction for IXT has become a routine practice across numerous institutions in China. However, the surgical success rate is not high and tends to decline with longer follow-up periods. In this article, we highlight key misconceptions and challenges in the surgical management of IXT, with focuses on optimizing the timing of surgical interventions, enhancing the preoperative evaluation, and advancing the standardization of surgical planning, aiming to provide evidence-based recommendations for clinical strategies and improve surgical outcomes of IXT.