Purpose: To evaluate the efficacy of bilateral lateral rectus muscle recession (BLR) to treat recurrent exotropia after bilateral medial rectus muscle resection (BMR). Methods: Twenty-four patients who underwent BLR for recurrent exotropia and were followed up for more than 6 months were included in this retrospective study. All of them had prior BMR. The angle of deviation, success rates, near stereopsis, and surgical effect of BLR were evaluated. Surgical success was defined as postoperative deviations ≤10 prism diopters (PD). Results: The overall mean follow-up time after reoperation for patients was 24.13 ± 15.01 months (range 6–60 months). The mean angle of deviation at distance was significantly reduced from –37.75 ± 14.93 PD to +1.50 ± 6.43 PD (p < 0.001). Twenty-two (91.6%) of 24 patients had successful outcomes, 1 (4.2%) had overcorrection, and 1 (4.2%) had undercorrection at the last follow-up. Improved stereopsis after reoperation was observed in 78.3% (18/23) of the patients. The mean surgical effect was 2.78 ± 0.71 PD/mm. Conclusion: Based on our results, BLR could be an effective and safe method for treating recurrent exotropia after a moderate to large amount of BMR.

1.
Leow
PL
,
Ko
ST
,
Wu
PK
,
Chan
CW
.
Exotropic drift and ocular alignment after surgical correction for intermittent exotropia
.
J Pediatr Ophthalmol Strabismus
.
2010
Jan-Feb
;
47
(
1
):
12
6
.
[PubMed]
0191-3913
2.
Kim
WJ
,
Kim
MM
.
The clinical course of recurrent intermittent exotropia following one or two surgeries over 24 months postoperatively
.
Eye (Lond)
.
2014
Jul
;
28
(
7
):
819
24
.
[PubMed]
0950-222X
3.
Yazdian
Z
,
Ghiassi
G
.
Re-recession of the lateral rectus muscles in patients with recurrent exotropia
.
J AAPOS
.
2006
Apr
;
10
(
2
):
164
7
.
[PubMed]
1091-8531
4.
Lueder
GT
,
Galli
M
.
Comparison of lateral rectus muscle re-recession and medial rectus muscle resection for treatment of postoperative exotropia
.
Am J Ophthalmol
.
2015
Apr
;
159
(
4
):
812
5
.
[PubMed]
0002-9394
5.
Ren
MY
,
Wang
T
,
Wang
Q
,
Guo
JL
,
Wang
LH
.
Unilateral medial rectus resection for the treatment of recurrent exotropia in children
.
Jpn J Ophthalmol
.
2015
Sep
;
59
(
5
):
341
5
.
[PubMed]
0021-5155
6.
Cho
KH
,
Kim
HW
,
Choi
DG
,
Lee
JY
.
Type of the recurrent exotropia after bilateral rectus recession for intermittent exotropia
.
BMC Ophthalmol
.
2016
Jul
;
16
(
1
):
97
.
[PubMed]
1471-2415
7.
Yang
HK
,
Hwang
JM
.
Bilateral vs unilateral medial rectus resection for recurrent exotropia after bilateral lateral rectus recession
.
Am J Ophthalmol
.
2009
Sep
;
148
(
3
):
459
65
.
[PubMed]
0002-9394
8.
Olitsky
SE
,
Kelly
C
,
Lee
H
,
Nelson
LB
.
Unilateral rectus resection in the treatment of undercorrected or recurrent strabismus
.
J Pediatr Ophthalmol Strabismus
.
2001
Nov-Dec
;
38
(
6
):
349
53
.
[PubMed]
0191-3913
9.
Nucci
P
,
Serafino
M
,
Trivedi
RH
,
Saunders
RA
.
One-muscle surgery in small-angle residual esotropia
.
J AAPOS
.
2007
Jun
;
11
(
3
):
269
72
.
[PubMed]
1091-8531
10.
Kim
JH
,
Kim
HJ
,
Choi
DG
.
Contralateral lateral rectus recession versus recess-resect for recurrent exotropia after unilateral recess-resect
.
Br J Ophthalmol
.
2013
Jun
;
97
(
6
):
752
6
.
[PubMed]
0007-1161
11.
Wright
KW
.
Color Atlas of Strabismus Surgery: Strategies and Techniques
. 3rd ed.
New York
:
Springer
;
2007
. pp.
219
20
.
12.
Choi
MY
,
Hyung
SM
,
Hwang
JM
.
Unilateral recession-resection in children with exotropia of the convergence insufficiency type
.
Eye (Lond)
.
2007
Mar
;
21
(
3
):
344
7
.
[PubMed]
0950-222X
13.
Isenberg
SJ
,
Abdarbashi
P
.
Drift of ocular alignment following strabismus surgery. Part 2: using adjustable sutures
.
Br J Ophthalmol
.
2009
Apr
;
93
(
4
):
443
7
.
[PubMed]
0007-1161
14.
Raab
EL
,
Parks
MM
.
Recession of the lateral recti. Early and late postoperative alignments
.
Arch Ophthalmol
.
1969
Aug
;
82
(
2
):
203
8
.
[PubMed]
0003-9950
15.
Hermann
JS
.
Surgical therapy of convergence insufficiency
.
J Pediatr Ophthalmol Strabismus
.
1981
Jan-Feb
;
18
(
1
):
28
31
.
[PubMed]
0191-3913
16.
ElKamshoushy
AA
.
Bilateral medial rectus resection for primary large-angle exotropia
.
J AAPOS
.
2017
Apr
;
21
(
2
):
112
6
.
[PubMed]
1091-8531
17.
Kang
SJ
,
Jang
JH
.
Motility restriction after resection of an extraocular muscle
.
Korean J Ophthalmol
.
2001
Dec
;
15
(
2
):
133
6
.
[PubMed]
1011-8942
18.
Chang
JH
,
Kim
HD
,
Lee
JB
,
Han
SH
.
Supermaximal recession and resection in large-angle sensory exotropia
.
Korean J Ophthalmol
.
2011
Apr
;
25
(
2
):
139
41
.
[PubMed]
1011-8942
19.
Li
JH
,
Zhang
LJ
.
Three-muscle surgery for very large-angle constant exotropia
.
J AAPOS
.
2013
Dec
;
17
(
6
):
578
81
.
[PubMed]
1091-8531
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