Slanted lateral rectus recession for exotropia with convergence weakness.

Abstract

To evaluate the efficacy of slanted recession of the lateral rectus (LR) muscle for exotropia (XT) with convergence weakness. Predesigned, nonrandomized, comparative trial. Twelve study patients and six control subjects with XT greater at near than at distance by > or =10 prism diopters (PD). Twelve consecutive patients underwent slanted LR recession, and six consecutive control subjects underwent standard LR recession. Between-groups comparison of the postoperative ocular alignment at distance and near, and the difference between them, as well as the stereopsis. Slanted LR recession reduced the XT to <8 PD in all patients at distance and in 11/12 patients at near. Additionally, the mean difference between the distance and near exodeviation was reduced from 14+/-4.5 PD preoperatively to 2.9+/-2.4 PD postoperatively. All patients in the control group demonstrated postoperative deviations of <8 PD at distance, but all had residual exodeviations >8 PD at near. Three of the study patients gained gross stereopsis postoperatively. Slanted recession of the LR is superior to standard recession in reducing both distance and near XT and in collapsing the difference between them. This technique may also have a positive impact on gross stereopsis.