Bilateral lateral rectus recession for exotropia: a survival analysis

Area of Science:

• Ophthalmology
• Pediatric Ophthalmology
• Strabismus Surgery

Background:

• Exotropia progression during childhood necessitates timely surgical intervention, though optimal timing remains debated.
• Bilateral lateral rectus recession is a common surgical approach for exotropia.

Purpose of the Study:

• To evaluate the long-term success rates of bilateral lateral rectus recession in exotropia patients.
• To identify predictive factors for surgical success and failure in exotropia treatment.

Main Methods:

• Survival analysis was used to assess time to failure after surgery in 57 exotropia patients.
• Failure was defined by persistent large angle deviations, esotropia, or need for re-operation.
• Patient age, deviation type, and pre-operative factors were analyzed as potential covariates.

Main Results:

• The overall success rate for exotropia surgery was 58%, with a mean time to failure of 68 months.
• Patients with intermittent exotropia demonstrated significantly better postoperative alignment compared to those with constant deviations.
• Pre-operative factors including age at surgery, deviation angle, and presence of amblyopia did not predict surgical outcomes.

Conclusions:

• Exotropia surgery success is not significantly influenced by patient age at the time of intervention.
• Intermittent exotropia is a favorable prognostic indicator for successful surgical correction compared to constant exotropia.