Bilateral lateral rectus recession for consecutive exotropia

Introduction: Treatment of consecutive exotropia after bilateral medial rectus recessions has been rarely studied. Though several series have reported results of medial rectus advancement, none has described results of lateral rectus recessions. Methods: We reviewed our results in 31 patients who underwent bilateral lateral rectus recessions for consecutive exotropia after bilateral medial rectus recessions. Mean follow-up was 30 months (range, 1-140 months) after the exotropia repair. Results: At last follow-up, 20 of 31 patients (65%) had deviations of less than or equal to 10 PD. Limitation of adduction was not apparent. Discussion: Cooper's dictum states that lateral rectus recession should be performed instead of medial rectus advancement. Our results suggest that this approach is generally successful. The outcome after exotropia repair in consecutive deviations is comparable to that after repair of primary exotropia. (J AAPOS 2000;4:291-4)