Bilateral Lateral Rectus Recession for the Treatment of Recurrent Exotropia after Bilateral Medial Rectus Resection

Abstract

Purpose: To evaluate the efficacy of bilateral lateral rectus muscle recession (BLR) to treat recurrent exotropia after bilateral medial rectus muscle resection (BMR). Methods: Twenty-four patients who underwent BLR for recurrent exotropia and were followed up for more than 6 months were included in this retrospective study. All of them had prior BMR. The angle of deviation, success rates, near stereopsis, and surgical effect of BLR were evaluated. Surgical success was defined as postoperative deviations ≤10 prism diopters (PD). Results: The overall mean follow-up time after reoperation for patients was 24.13 ± 15.01 months (range 6–60 months). The mean angle of deviation at distance was significantly reduced from –37.75 ± 14.93 PD to +1.50 ± 6.43 PD (p < 0.001). Twenty-two (91.6%) of 24 patients had successful outcomes, 1 (4.2%) had overcorrection, and 1 (4.2%) had undercorrection at the last follow-up. Improved stereopsis after reoperation was observed in 78.3% (18/23) of the patients. The mean surgical effect was 2.78 ± 0.71 PD/mm. Conclusion: Based on our results, BLR could be an effective and safe method for treating recurrent exotropia after a moderate to large amount of BMR.

Management of Abnormal Visual Developments

“…Many factors can affect the correction results, such as the nature of muscle, the relationship with surrounding tissues, and different nerve impulses. Overcorrection and undercorrection are relatively common problems that occur after surgery for strabismus [78], therefore it may take more than one operation to get satisfactory results.…”