Reversal of unilateral medial rectus recession and lateral rectus resection effectively correct secondary exotropia

This study's authors reviewed the charts of 52 patients operated on by one surgeon for consecutive exotropia and followed for at least six weeks (mean 2.5 years). The indication for surgery was a cosmetically unacceptable exotropia, most commonly of more than 15 prism diopters (PD). The medial rectus was advanced to the original insertion and the lateral rectus recessed by the number of millimeters it had originally been resected for patients with records of their previous surgery. The mean preoperative distance exodeviation was 33.4 PD, and the mean angle of strabismus reduction was 33.5 PD.

Surgery was deemed a success, defined as ocular alignment within 10 PD of orthophoria at final follow-up, in 41 patients (78.8 percent). The dose-effect relationship between the reduction in the angle of deviation and the sum of the millimeters of reoperation was a mean of 2.9 PD/mm and strongly correlated with the amount of preoperative exodeviation, although it varied widely among patients.