Determinents of ocular alignment at 6 month after intermittent exotropia surgery

Purpose: To evaluate postoperative ocular alignment at day 1 and at 6 months after unilateral LR recessionmedial rectus (MR) resection bilateral LR recession for Intermittent exotropia. Materials and Methods: Retrospectively medical records of 30 patients who underwent unilateral LR recession with MR resection and bilateral LR recession for intermittent exotropia were evaluated at postop day 1 & at 6 months. Each patient underwent complete orthoptic examination and had surgery plan for orthophoria. Surgical outcomes in reference of postoperative angle were compared & grouped as group A (esotropia 8-15 PD), group B (Orthotropia or esotropia/exotropia- 8 PD) & group C (exotropia>8-15 PD). Success alignment was defined as orthotropia or esotropia/ exotropia wihtin 6-8 PD. Results: Out of 30 patients, 19 underwent unilateral LR recession with MR resection & 11 underwent and bilateral LR recession. Pre-operative. Mean angle was 49.5(30-55 PD). Surgical outcome at post-operative day 1 in group A, B,C were 10%, 73.3%,16.7% respectively. Surgical outcome at 6 months in group A, B & C were 3.4%, 76.6% & 20% respectively. Surgical success at early ocular alignment and at 6 months 73.3% and 76.6% respectively. At 6 months success outcome in BLR was 81.8% & that in R/R was 73.6%. Conclusion: Early postoperative ocular alignment of intermittent exotropia at day 1 can be a determinant of orthophoria at 6 months. Orthophoric or slight overcorrection gives better ocular alignment but, prediction of long-term ocular alignment remains a grey zone. Keywords: Alignment, Bilateral LR recession, Intermittent Exotropia, Unilateral LR recession- MR resection.