Consecutive esotropia in contralateral recess-resect for recurrent intermittent exotropia after unilateral recess-resect

Purpose To report consecutive esotropia in contralateral recess-resect for recurrent intermittent exotropia after unilateral recess-resect. To evaluate the surgical outcome of ‘modified contralateral recess-resect’ for intermittent exotropia after unilateral recess-resect. Methods 36 subjects were included in this retrospective study. All underwent, as a primary surgery for intermittent exotropia, unilateral recess-resect on the non-dominant eye. They were assigned to the subsequent contralateral recess-resect(CRR, n = 19, surgical dosages based on Wright's surgical table) or modified contralateral recess-resect (MRR, n = 17, surgical dosages 5Δ reduced on Wright's surgical table) for recurrent exotropia. Surgical success rate was evaluated. Re-operation rate or prism glasses prescription rate due to consecutive esotropia was evaluated. Results The mean follow-up duration after the reoperation was 25.8 months in CRR group and 24.0 months in MRR group. Surgical success rate was 47.4% in CRR group and 76.5% in MRR group (p = 0.078). Recurrence rate was 0% in CRR group and 17.6% in MRR group (p = 0.059). Re-operation rate or prism glasses prescription rate due to consecutive esotropia was 52.6% in CRR group and 5.9% in MRR group (p = 0.003). Conclusions Final outcomes were better in MRR group than in CRR group. Consecutive esotropia was significantly more frequent in CRR group than in MRR group. To reduce consecutive esotropia in surgery for recurrent exotropia, MRR is recommended.