Bilateral lateral rectus muscle recession for the convergence insufficiency type of intermittent exotropia

Abstract

To evaluate the surgical efficacy of bilateral lateral rectus recession (BLRR) for intermittent exotropia with convergence insufficiency (CI-type X[T]). The medical records of patients with CI-type X(T) who underwent BLRR on adjustable suture from January 2011 to March 2014 were retrospectively reviewed. Ocular alignment and sensory status were evaluated pre- and postoperatively for each patient. The mean distance and mean near deviation, before and after surgery, as well as the mean near-distance difference, were compared. Success was defined as postoperative alignment of esophoria/tropia of ≤5(Δ) and exophoria/tropia of ≤8(Δ) at distance. A total of 25 patients were included. The mean exodeviation was significantly reduced, from 32.5(Δ) preoperatively to 0.08(Δ) postoperatively (P<0.001) at distance and from 45(Δ) preoperatively to 2.4(Δ) (P<0.001) postoperatively at near. The mean near-distance difference was reduced from 16(Δ) preoperatively to 2(Δ) postoperatively (P<0.01). Of the 25 patients, 21 (84%) obtained successful motor alignment, 2 had recurrent exodeviation of ≥10(Δ) at distance, and 2 had overcorrected esotropia with deviation angles of >8(Δ). In this cohort of patients, bilateral lateral rectus recession using an adjustable suture technique successfully treated CI-type X(T).