Re-recession of the Lateral Rectus Muscles In Patients With Recurrent Exotropia

Purpose: We undertook a retrospective evaluation of changes in deviation and ocular motility after surgical rerecession of the lateral rectus (LR) muscles as a treatment for recurrent exotropia (XT). Methods: We describe 16 consecutive patients (age 6 to 35 years; median, 10 years; 13 children and 3 adults) with an average amount of recurrent alignment, amount of rerecession, distance from insertion to the limbus, postoperative alignment, and versions. Results: In most cases, bilateral LR muscles were rerecessed to a distance of 15 mm from the limbus, but in 5 cases with larger amount of deviation, these muscles were rerecessed to 17 mm from the limbus. A relation was found between the amount of rerecession and change in far alignment in prism diopters (r = 0.46, P = 0.07), but not for near deviation. The success rate (esotropia ≤ 10 PD or exotropia ≤ 8 PD) 1 to 7 days after surgery and in long-term follow-up (6-96 months; median, 25.5 months) was 100%. No significant underaction of the LR muscles was noted. Conclusions: The results support the notion that bilateral LR rerecession to 17 mm from the limbus successfully corrects recurrent exotropia up to 33 PD and that it is particularly effective in children and adults without producing significant limitation of abduction.