Early postoperative angle for prediction of surgical success for exotropia
Reviewed by Fiona Rowe

In this study, the authors assessed the relationship between the initial postoperative deviation and surgical outcomes in adult exotropia undergoing unilateral lateral rectus recession with medial rectus resection. The study included 93 patients (51 female); 26 with residual exo, 53 with eso within 10PD, and 14 with eso >10PD at two weeks postoperative. Mean age at surgery was 37.4 ±20.2 years, preoperative stereoacuity was 166 ±137”, near prism fusion base out range was 16 ±11PD, and mean distance angle of deviation was 27 ±12PD and, for near, 31 ±11PD. Sixty had basic exotropia, 25 convergence insufficiency type and eight divergence excess type. Mean follow-up was 264 ±141 days. At final follow-up, surgical success was 61% (57 patients). Failure for surgery included 18 consecutive esotropia and 16 recurrent exotropia >10PD. Exotropia angle progressively increased over the postoperative follow-up period. The authors conclude the initial postoperative alignment can serve as a predictor of surgical success for intermittent exotropia cases. Overcorrection within 10PD at one week postoperative is associated with more favourable surgery outcomes than residual exotropia or esotropia >10PD.

Early post-operative angle as a predictor of surgical success in adult patients with intermittent exotropia.
Narayan A, Dosanjh S, Dominic J, Jain S.
STRABISMUS
2023;31(2):152–8.