Purpose The purpose of this study is to evaluate prognostic factors, specifically age, at the time of surgery, for recurrence after bilateral lateral rectus recession (BLR) in patients with intermittent exotropia. Methods Medical records of 511 subjects who underwent BLR procedures between the ages of 3 and 10 years with more than 12 months of follow-up were retrospectively reviewed. Patients' surgical outcomes with a deviation of less than 10 prism diopters (PD) exotropia and less than 5 PD esotropia were defined as a success. Outcomes with more than 11 PD exotropia were designated as recurrences, and those with esotropia of more than 5 PD after 3 months of surgery were noted as overcorrection. Prognostic factors for recurrence were analyzed by multivariate logistic regression test. Results Of the 511 subjects, 371 had successful surgical outcomes and 129 had recurrences, whereas 11 were found to be overcorrected. Age at surgery and immediate postoperative alignment proved to be significant factors influencing a favorable outcome by multivariate logistic regression analysis (Po0.05). However, gender, photophobia, age at onset, spherical equivalent (SE) refractive error, astigmatism, SE anisometropia, and preoperative deviation size were not significantly predictive of success (P40.05). Conclusion In BLR procedures, increasing patient age at surgery was associated with lower recurrence rates.

Purpose To evaluate the prognostic factors, particularly age at the time of surgery, for recurrence after unilateral medial rectus resection and lateral rectus recession (R&R) procedures in patients with intermittent exotropia, or X(T). Methods Medical records of 489 subjects who received unilateral R&R procedures with more than 12 months of follow-up were reviewed. The patients' surgical outcomes with a deviation of less than 10 prism diopters (PD) of exotropia and less than 5 PD of esotropia were defined as a success. Outcomes with more than 11 PD of exotropia were designated as recurrences, and those with esotropia of more than 5 PD after 3 months of operation were noted as overcorrection. The prognostic factors for recurrence were analyzed by the multivariate logistic regression test. Results Of the 489 subjects, 209 had successful surgical outcomes and 280 had recurrences, whereas overcorrection was not found. Mean age at operation was 8.9 ± 6.5 years, mean preoperative distant X(T) size was 32.9 ± 6.0 PD, and mean follow-up period was 27.5 ± 17.9 months. On the basis of the survival analysis in which survival represented time of recurrence, the mean duration was 31.2±1.7months. Age at onset, age at surgery, and immediate postoperative alignment proved to be significant factors influencing a favorable outcome by multivariate logistic regression analysis (Po0.05). However, gender, family history, and preoperative deviation size were not significantly predictive of success (P40.05). ConclusionIn unilateral R&R procedures, increasing patient age at the time of surgery was associated with lower recurrence rates. Recurrence rates also increased with the immediate postoperative angle and with the postoperative angle of deviation at 1, 3, 6, and 12 months.

Purpose The aim of this study is to investigate the difference of the clinical course in recurrent intermittent exotropia after second surgery compared with both recurrent intermittent exotropia after its first of two surgeries and intermittent exotropia after only a single surgery. Methods We retrospectively reviewed the medical records of patients diagnosed with intermittent exotropia who underwent lateral rectus recession and medial rectus resection (R&R) between January 1992 and January 2011 at Yeungnam University Hospital. Repeated measure ANOVA (rmANOVA) was used to compare the clinical course of recurrent intermittent exotropia before and after a second surgery with that of intermittent exotropia with a single surgery. Results A total of 352 intermittent exotropia patients who underwent one R&R procedure and 77 recurrent intermittent exotropia patients who underwent a second R&R in the contralateral eye were included in this study. Although exodrift of recurrent intermittent exotropia was observed at 24 months of follow-up even after a second surgery, it was significantly lower than both intermittent exotropia with a single surgery and after its first of two surgeries (Po0.001, rmANOVA). Conclusion The clinical course of recurrent intermittent exotropia after a second surgery was improved compared with both recurrent intermittent exotropia after its first of two surgeries and intermittent exotropia after a single surgery.