Exotropic drift and ocular alignment after surgical correction for intermittent exotropia.

PURPOSE

To evaluate changes in the angle of deviation over time and compare the motor success rate with different initial postoperative deviation in patients undergoing surgical correction for intermittent exotropia.

METHODS

Forty-eight patients aged between 1 and 10 years who underwent bilateral lateral rectus recession for intermittent exotropia were retrospectively evaluated. Preoperative and postoperative ocular deviations at 1 week, 1 month, and 6 months were analyzed. Full surgical correction was attempted in all patients. Motor success was defined as ocular deviation within 10 prism diopters of orthophoria at 6 months postoperatively.

RESULTS

The follow-up period ranged from 6 months to 3 years. Although most patients had exotropic drift, this drift was greater in patients with initial esotropia (86.7%) and orthophoria (70.0%) compared to patients with exotropia (26.1%). Motor success was achieved in 29 (60.4%) patients. There was no statistical difference between ocular alignment at 1 week postoperatively and final motor success (P = .782). There was good correlation between ocular alignment at 1 week and 6 months postoperatively (rho = 0.585, P < .001). Age and preoperative deviation were not found to be associated with motor success.

CONCLUSIONS

The success rate appears to be unaffected by initial ocular alignment, suggesting that deliberate initial overcorrection may be unnecessary. Future studies are warranted to evaluate the long-term stability of this alignment.