Treatment of consecutive exotropia by bimedial rectus advancement in comparison with bilateral lateral rectus recession

Abstract

Introduction Consecutive exotropia has been reported in 20–27% of patients following surgical correction of esotropia. However, higher rates have been reported with longer durations of follow-up. Surgical options for correction of consecutive exotropia include medial rectus advancement, medial rectus resection and advancement, lateral rectus recession, and a combination of these methods. Purpose The aim of this study was to compare the effectiveness of both bilateral medial rectus advancement and bilateral lateral rectus recession in the management of consecutive exotropia. Patients and methods This study included 20 patients with consecutive exotropia. Patients presenting with exotropia of at least 20 prism diopter (PD), with a history of bilateral medial rectus recession, were included. Ten patients underwent bimedial rectus advancement and 10 patients underwent bilateral lateral rectus recession. They were followed up for 1 year. Results The mean age of the patients was 6.7±3.2 (range 3–10 years). Mean preoperative exotropia was 28.8±5.3 PD. Successful alignment was achieved in 70% of cases treated by bimedial rectus advancement and 80% of cases treated by bilateral lateral rectus recession. Conclusion There was no significant difference between bilateral medial rectus advancement and bilateral lateral rectus recession in the treatment of consecutive exotropia.