Long-term results of surgery for intermittent exotropia

Objective: To evaluate the long-term surgical outcomes in a population with intermittent exotropia X(T) who were operated by the same surgeon. Material and Methods: The medical records from January 1991 to December 2008 were retrospectively reviewed. Patients were examined on postoperative day 1, in week 1 and week 6, at 6 months and 1 year, and then every year. Twenty four of 43 patients underwent bilateral lateral rectus recession and 19 patients underwent unilateral recession-resection for X(T). Results: Forty-three patients underwent surgery at a mean age of 11.2±4.6 years (range, 6 to 25 years). Eleven of the 43 children (25.6%) underwent a second surgical intervention (9 for recurrent exotropia and 2 for consecutive esotropia), and no patient received more than 2 interventions. Four patients were lost to follow-up after 2 years. Mean follow-up time was 9±5.2 years for 39 patients. Consecutive esotropia (ET) developed in 9 (21%) patients with immediate overcorrection of at least 20 prism diopters (PD). Only two cases of consecutive ET required second surgery. Postoperative esodeviation developed in almost all cases and it showed a tendency to progress to exodeviation with longer follow-up time. Nine cases required surgery for residual or recurrent exotropia. Finally, 28 of the 39 (71.8%) were within 10 PD of or- thotropia at distance and 18 of 39 (46.2%) had a stereopsis better than 60 seconds of arc. Conclusion: In this population with intermittent exotropia, although 11 cases underwent a second surgical intervention, after a mean follow-up of 9.8 years, approximately 3 out of 4 cases were successfully aligned and 46.2% had high-grade stereopsis.