Management of Intermittent Exotropia

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Abstract
To study the long range results of surgically treated intermittent exotropia, 100 consecutive patients have been followed for an average of 9.06 years. In all cases, the initial procedure was bilateral recession of the lateral rectus muscles. The overall functional cure rate was 77 percent. To accomplish this result, 27 patients were operated on a second time, 21 for undercorrection and six for overcorrection. A number of patients cooperated very poorly or were lost to follow-up while still under treatment. Had these patients been eliminated from the series, the cure rate would have been greater than 90 percent. In this study, patients who were undercorrected or had recurrence of the intermittent exotropia were placed in base-in prisms to allow constant fusion for a minimum of six months before further surgery was carried out. Similarly, patients whose overcorrection did not respond to patching were placed in base-out prisms to permit fusion in daily life. Also, with these patients, further surgery was not carried out until the prisms had been worn for at least six months.