Surgical Outcomes of Consecutive Exotropia – A Retrospective Analysis from a Tertiary Eye Hospital

Abstract

Purpose: To determine the surgical outcomes of medial rectus advancement alone or in combination with lateral rectus recession in the management of patients with consecutive exotropia. Materials and Methods: A retrospective analysis of 20 patients who underwent surgical correction for consecutive exotropia (XT) between January 2019 and June 2022 was conducted. Patients underwent either medial rectus advancement (Group 1) or combined medial rectus advancement and lateral rectus recession (Group 2). Patients were followed up for a minimum period of 1 month postoperatively, and the correction obtained per mm of muscle operated was analysed. Results: Twenty patients (8 females, 12 males) were enrolled in the study. The mean age at primary surgery for esotropia was 6.25 ± 4.67 years, and the mean age at surgery for XT was 23.1 ± 9.47 years. At the present surgery for XT, the mean distance deviation was 43.05 ± 13.79 prism diopter (PD) of exotropia and the mean near deviation was 43.55 ± 15.21 PD of exotropia. Group 1 consisted of five patients, and Group 2 consisted of 15 patients. Postoperatively, the mean distance deviation was 7.6 ± 6.21 PD (range: 6 PD esophoria–18 PD XT) and the mean near deviation was 7.0 ± 6.07 PD (range: 6 PD esophoria–20 PD XT). The mean correction obtained postoperatively was 36.0 ± 12.49 PD. The mean correction obtained per mm of muscle operated was 3.45 ± 0.61 PD. Conclusion: Medial rectus muscle advancement with or without lateral rectus recession is an effective surgical method for the treatment of XT, and the mean correction obtained per mm of muscle operated was 3.45 ± 0.61 PD. Careful history taking, analysing previous surgery details, preoperative planning, and intraoperative exploration of muscles are important for managing eyes with XT.