Long-term Motor and Sensory Outcomes After Unilateral Lateral Rectus Recession-Medial Rectus Resection for Infantile Constant Exotropia.

PURPOSE: To report long-term motor and sensory outcomes after unilateral lateral rectus recession-medial rectus resection for infantile constant exotropia.

METHODS

The medical records of patients who had undergone unilateral lateral rectus recession-medial rectus resection for infantile constant exotropia who were followed up postoperatively for a minimum of 4 years were reviewed retrospectively.

RESULTS

A total of 20 patients were included. The mean age at surgery was 3.21 ± 1.54 years (range: 1.25 to 6.00 years). The mean duration of exodeviation was 2.99 ± 1.61 years (range: 9 months to 6 years). The mean angle of exodeviation was 70.1 ± 20.9 prism diopters (PD) (range: 35 to 90 PD). The median postoperative follow-up was 9.1 years (range: 4 to 24 years). Overall, 12 patients (60%) had surgical success at their last follow-up visit. Age at first surgery, cycloplegic refraction, strabismus duration, preoperative angle of deviation, presence of amblyopia, and the number of exotropia surgeries did not predict motor outcome after surgery. At the last follow-up visit, 20% of patients had residual exotropia and 15% had recurrent exotropia. Peripheral binocular single vision was achieved in 25% of patients and stereopsis in none. Age at first surgery, strabismus duration, and surgical outcome had no effect on sensory outcome.

CONCLUSIONS

In this study, 60% of patients achieved a successful long-term motor outcome and 25% achieved peripheral binocular single vision after unilateral recession-resection for infantile constant exotropia. Stereopsis outcome was nil. Age at surgery and duration of strabismus had no effect on motor and sensory outcomes. [J Pediatr Ophthalmol Strabismus. 2025;62(3):203-210.].