Contralateral lateral rectus recession versus recess-resect for recurrent exotropia after unilateral recess-resect.

Background: To compare outcomes following contralateral lateral rectus (LR) recession and recess-resect (RR) procedures for recurrent exotropia of 20-25 prism dioptres (PD) after unilateral RR.

Methods: 39 subjects were included in this retrospective study. All underwent, as a primary surgery for intermittent exotropia, unilateral RR on the non-dominant eye. They were assigned to the subsequent contralateral LR recession (LR, n=19) or RR (n=20) group for recurrent exotropia of 20-25 PD. Surgical success was defined as alignment between 5 PD esodeviation and 10 PD exodeviation.

Results: The mean follow-up duration after the reoperation was 32.3±26.4 months in the LR group and 30.5±26.8 in the RR group (p=0.945). The mean deviation angles at postoperative 1 day were -0.7 PD (overcorrection) in the LR group and -4.3 PD in the RR group (p=0.047). The deviation angles at 3 and 6 months postoperatively were not significant (p=0.771, p=0.923). The final successful outcome was achieved in 63.2% of patients in the LR group and in 65% of patients in the RR group (p=0.905).

Conclusions: Contralateral LR recession was found to be a safe and effective procedure for the treatment of recurrent exotropia of 20-25 PD after unilateral RR for intermittent exotropia. With LR recession, the intentional overcorrection in the immediate postoperative period could be avoided.