DELAYED CONSECUTIVE EXOTROPIA FOLLOWING 7-MILLIMETER BILATERAL MEDIALRECTUS RECESSION FOR CONGENITAL ESOTROPIA

The rate of delayed consecutive exotropia after bilateral 7-millimeter medial rectus recession for large angle congenital esotropia in 88 pa tients was 27% (24/88), larger than previously reported. The rate was 38% (8/21) in infants having surgery prior to 7 months of age, 20% (10 /49) in infants undergoing surgery at 7 to 12 months of age, and 33% ( 6/18) in patients undergoing surgery at 13 months of age or later. The onset of consecutive exotropia averaged 26.8 months postoperatively, allowing a long period of good alignment for binocular vision to devel op before exotropia surgery was required. Physicians and parents shoul d be aware that delayed consecutive exotropia may develop several year s postoperatively. Since delayed consecutive exotropia may be characte ristic of the 7-millimeter recession procedure or characteristic of al l patients who have had surgery for congenital esotropia, a prospectiv e long-term study to compare the 7-millimeter procedure with the three - and four-muscle procedure would be helpful.