Timely surgery in intermittent and constant exotropia for superior sensory outcome

PURPOSE: To determine whether time of strabismus surgery for patients with acquired intermittent exotropia and constant exotropia influences postoperative sensory outcome. METHODS: In a retrospective, cross-sectional study, 76 patients with acquired intermittent or constant exotropia and motor realignment were evaluated for postoperative sensory status. Age at surgery, duration of exotropia, and presence of intermittent or constant exotropia were correlated with postoperative sensory status. The 23 male and 53 female patients had an average age of 9.3 years at the time of surgery and a mean follow-up of 5.9 years. RESULTS: Patients had a significantly greater chance of having postoperative stereoacuity better than 60 seconds of arc (bifixation) if they were surgically aligned before 7 years of age ( P < .01) or before 5 years of strabismus duration ( P < .05), or with intermittent as compared with constant exotropia ( P < .001). Patients with postoperative bifixation had earlier surgical intervention ( P < .025) and shorter duration of exotropia ( P < .025) than those with postoperative monofixation. CONCLUSIONS: Patients with intermittent or constant exotropia may achieve superior sensory outcome with motor realignment before age 7, before 5 years of strabismus duration, or while the deviation is intermittent.