Factors associated with the recurrence of intermittent exotropia and reoperations in the long term

PURPOSE: To evaluate long-term reoperation risk after bilateral lateral rectus (BLR) recession for intermittent exotropia (IXT) in a paediatric cohort, and to identify the perioperative factors associated with recurrence and reoperation. METHODS: < 0.05. RESULTS: = 0.024) were independently associated with reoperation. Orthoptic and occlusion therapies showed non-significant trends. CONCLUSION: In children undergoing BLR for IXT, initial surgical failure and deviation magnitude (pre- and immediate postoperative) are the strongest predictors of reoperation, with age having the modest additional effect. These findings emphasize precise surgical planning and the need for long-term follow-up.