Indications and results of exotropia surgical management

AIM: To study the clinical particularities and the surgical management of the different forms of exotropia, and to analyze the prognostic factors influencing the surgical result. METHODS : Medical records of 132 patients who underwent exotropia surgery from 1995 to 2015, were retrospectively reviewed. Ophthalmological examination and a complete sensorimotor assessment were performed for each patient. All surgeries were performed by the same surgeon. RESULTS: We had 57 cases of intermittent exotropia (IE), 22 cases of infantile exotropia (IfE), 43 cases of sensory exotropia (SE) and 10 cases of concecutive exotropia (CE). The average age of onset of exotropia was 6.8 years +/- 8 SD. Amblyopia was noted in 36.4% of cases of IfE. The mean deviation angle was 36.5 DP in (IE), 39.6 DP in (IfE) and 44.5 DP in (SE). A vertical syndrome was frequently found in (IfE) patients. Bilateral recession of lateral rectus was the most performed surgery type. The overall success rate after a single surgery was 72%. A multivariate logistic regression analysis showed that good prognosis factors were the absence of amblyopia, the intermittent form of the strabismus, a low preoperative deviation angle and the ocular alignment on day one postoperatively. CONCLUSION : IE is the most common divergent strabismus. Surgery resulted in successful alignment in most of the cases. Early management and rigorous analysis of patients sensorimotor status are the best guarantors of long-term success