Long-term motor and sensory outcomes after unilateral recession-resection for pseudodivergence excess intermittent exotropia

Purpose: To report long-term motor and sensory outcomes after unilateral recess-resect surgery for pseudodivergence excess intermittent exotropia. Materials and Methods: The medical records of patients who underwent unilateral lateral rectus recession-medial rectus resection for pseudodivergence excess intermittent exotropia and followed postoperatively for at least 5 years were reviewed retrospectively. Results: A total of 21 patients were included. The mean age at surgery was 11.5 ± 6.3 years. The mean postoperative follow-up was 7.8 ± 2.7 years (range: 5–13 years). Overall, 11 patients (52%) had surgical success at their last follow-up. Strabismus duration, near and distance deviations, fusion at distance, and stereoacuity did not predict motor outcome after surgery. One patient (100%) without fusion at near and 10 of 15 patients (67%) without fusion at distance preoperatively exhibited fusion at their last follow-up. Six out of eight patients (75%) with a preoperative stereoacuity of 120–1980 arcsec and two out of three patients (67%) with nil stereopsis achieved a stereoacuity of 60 arcsec. Overall, 10 patients (48%) had a recurrence of intermittent exotropia at a mean 2.5 years after surgery. Conclusions: Nearly half of our patients with pseudodivergence excess intermittent exotropia achieved a successful long-term ocular alignment after unilateral recess-resect surgery. A large majority of patients who preoperatively had a subnormal or nil stereoacuity exhibited postoperatively a normal stereoacuity at the last follow-up visit.