Long-term outcomes better with bilateral lateral rectus recession for intermittent exotropia

Am J Ophthalmol. 2012:153(2);343-351.

Among children with intermittent exotropia, surgical outcomes did not differ between bilateral lateral rectus recession and unilateral lateral rectus recession-medial rectus resection. However, final outcomes at more than 3 years after surgery were better in the bilateral lateral rectus recession group.

Researchers conducted a retrospective review of the difference in long-term surgical outcomes with the two techniques. They enrolled 128 children, of which 55 underwent bilateral lateral rectus recession and 73 underwent unilateral lateral rectus recession-medial rectus resection between July 2002 and May 2006. Subjects had at least 2 years of follow-up.

Results showed that surgical outcomes in the two group were not different at 1 day, 1 month, 6 months, 1 year and 2 years after surgery. Final outcomes measured at a mean of 3.8 years after surgery showed that the bilateral lateral rectus recession group had a higher success rate (58.2%) than the unilateral lateral rectus recession-medial rectus resection group (27.4%; P < .01).

“This may be attributable to a difference in recurrence rate over time: continuous recurrence of exotropia occurred in the [unilateral lateral rectus recession-medial rectus resection] group, while recurrence was low in the [bilateral lateral rectus recession] group,” the researchers said.