Comparative study of lateral rectus recession versus recession-resection in unilateral surgery for intermittent exotropia.

Objective: To compare the outcomes of unilateral lateral rectus recession to unilateral recession-resection in the treatment of patients with intermittent exotropia.

Methods: The medical records of patients with intermittent exotropia with exodeviation of 20(Δ) to 25(Δ) who underwent unilateral lateral rectus recession or recession-resection at a single center from 2002 to 2010 were retrospectively reviewed, and surgical outcomes between groups were compared.

Results: Of 70 patients, 37 underwent lateral rectus recession; 33, recession-resection. The mean preoperative exodeviation was 22.2(Δ) ± 2.1(Δ) at distance and 22.3(Δ) ± 3.3(Δ) at near in the lateral rectus group and 24.5(Δ) ± 1.4(Δ) at distance and 26.4(Δ) ± 3.6(Δ) at near in the recession-resection group. Successful surgical outcome was defined as esodeviation of ≤5(Δ) to exodeviation of ≤10(Δ) at distance in primary position. The mean follow-up period was 37.1 months in the lateral rectus group and 44.6 months in the recession-resection group (P = 0.078). The surgical success did not differ significantly between groups at the final follow-up (45.9% in the lateral rectus group and 39.4% in the recession-resection group; P = 0.215). However, posteroperative overcorrection was less common in the lateral rectus group through 12 months' follow-up.

Conclusions: Surgical outcomes at a mean of 3.4 years did not differ significantly between groups. In our study cohort, unilateral lateral rectus recession showed a low risk of overcorrection in the treatment of mild to moderate angle exotropia.