Long-term surgical outcomes of patients with consecutive exotropia

Purpose To evaluate the long-term surgical outcome of patients with consecutive exotropia. Methods Patients who underwent surgery for the treatment of consecutive exotropia between January 2008 and July 2016 with a minimum follow-up period of 2 years were retrospectively reviewed. Surgical outcomes were classified based on postoperative angle of deviation at 2 years as follows: success (esodeviation ≤ 5 prism diopters [PD] to exodeviation ≤ 10 PD), and recurrence [exodeviation > 10 PD]). Postoperative angles of deviation at 1 week, 1 month, 6 months, 1 year, and 2 years and at the final follow-up were investigated. Results A total of 37 patients (28 in the success group and 9 in the recurrence group) were included. Surgical success rate at 2 years was 75.7%, and reoperation rate was 10.8% during a mean follow-up period of 42.4 ± 18.3 months after consecutive exotropia surgery. After surgery, exodrift occurred mostly during 1-month follow-up in both groups, and those with no exodrift within 1 month presented a higher surgical success. Thereafter, patients in the success group showed a more stable course during follow-up than those in the recurrence group. Stereopsis was an important factor associated with surgical outcome. Conclusions Exodrift occurs mostly within 1 month after surgery for consecutive exotropia. Targeting initial overcorrection and establishing esodeviation at postoperative month 1 is important to achieve successful results.