Comparative study of standard and augmented bilateral lateral rectus recession for intermittent exotropia

To investigate the long-term surgical outcomes of augmented bilateral lateral rectus recession (BLRrec) for intermittent exotropia (XT). Patients treated with BLRrec for basic-type XT were divided into two groups. In the standard surgery group, the standard formula for BLRrec was used, whereas in the augmented surgery group, 1.0–1.5 mm was added bilaterally to the standard formula for BLRrec. Patients were followed up for 3 years. In total, 119 patients were enrolled, including 56 in the standard surgery group and 63 in the augmented surgery group. The success rate in the augmented surgery group was 44.4% at 3 years, which was higher than that in the standard surgery group (25.0%; P = .011). The incidence of consecutive esotropia (ET) was significantly higher in the augmented surgery group 1 year after surgery; however, the significance disappeared after 2 years. Immediate postoperative overcorrection in the standard surgery and augmented surgery groups was 14.8 prism dioptre (PD) ET and 21.0 PD (P < .001), respectively; moreover, the total exotropic drift at 3 years was 25.6 PD and 27.9 PD (P = .602), respectively. Augmented BLRrec showed better long-term surgical outcomes than standard BLRrec because of the larger immediate postoperative overcorrection. Although consecutive ET was more frequent in the augmented surgery group in the first year after surgery, it gradually resolved with conservative management.