• Gregg T Lueder and Marlo Galli.
• Departments of Ophthalmology and Visual Sciences and Pediatrics, St Louis Children's Hospital, Washington University School of Medicine, St Louis, Missouri. Electronic address: Lueder@vision.wustl.edu.
• Am. J. Ophthalmol. 2015 Apr 1; 159 (4): 812-5.

PurposeTo compare the outcomes of unilateral lateral rectus muscle re-recession and medial rectus muscle resection for treatment of recurrent or persistent exotropia.DesignRetrospective nonrandomized clinical trial.Methodssetting: Hospital-based clinical practice.Patient PopulationForty patients with recurrent or persistent exotropia following bilateral lateral rectus muscle recessions.InterventionFourteen patients were treated with unilateral medial rectus muscle resection and 26 with unilateral lateral rectus muscle re-recession.Main Outcome MeasuresOutcomes were considered successful if the patients had deviations less than 10 prism diopters (PD) at last follow-up. All patients were followed for at least 1 year postoperatively.ResultsThe mean preoperative deviations were 17.4 PD in the medial rectus muscle resection group and 18.1 PD in the lateral rectus muscle re-recession group. Successful outcomes were achieved in 9 of 14 patients (64%) treated with medial rectus muscle resection and 19 of 26 patients (73%) treated with lateral rectus muscle re-recession. There was no statistically significant difference between these outcomes. Mean follow-up was 4.5 years in the medial rectus muscle resection group and 2.9 years in the lateral rectus muscle re-recession group.ConclusionsSurgery on a single muscle can be used to treat moderate-angle recurrent or persistent exotropia. Unilateral re-recession of the lateral rectus muscle and medial rectus muscle resection have equivalent success rates.Copyright © 2015 Elsevier Inc. All rights reserved.

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