Clinical Features of Patients who Revisited Our Clinic after 3 Years of Postoperative Intermittent Exotropia Stabilization

Purpose: To analyze the chief complaints and clinical characteristics of patients with intermittent exotropia who voluntarily revisited our clinic more than 3 years after stabilization of bilateral lateral rectus recession.Methods: This study retrospectively reviewed the medical records of patients diagnosed with intermittent exotropia who underwent bilateral lateral rectus recession and revisited the outpatient clinic after more than 3 years of follow-up.Results: Thirty-two patients were included. The most common reason for voluntary revisit was suspicion of recurrence (n = 21, 65.6%). Reasons for revisit were divided into suspicion of recurrence (exodrift group) and others (no exodrift group). At the revisits, both the distance and near deviation angles of the exodrift group were larger than those of the no exodrift group. For all patients and the exodrift group, both the distance and near deviation angles were higher at the revisits than at the last follow-up visits. For both groups, the near stereoacuity did not differ between the last follow-up visit and the revisit but the spherical equivalent was more myopic at the revisit than the last follow-up visit in all eyes except the left eyes of the no exodrift group. The deviation angles of 11 patients who underwent continuous follow-up after the revisits did not significantly change over 1 year after full correction of the refractive error, with the exception of 1 who underwent re-operation.Conclusions: When patients stabilize after intermittent exotropia surgery, the decrease in the corrected visual acuity triggers fusional convergence deterioration and, in turn, unstable strabismus. However, after full correction of the refractive error, the deviation angle stabilizes without further progression. It is important to explain this to patients/guardians at the end of initial follow-up.