Treatment of intermittent exotropia in children using a lateral rectus fenestration technique

PURPOSE To report the results of bilateral fenestration of the lateral rectus muscle in cases of intermittent exotropia in pediatric patients.METHODS Children <12 years of age with basic and pseudo-divergence excess type intermittent exotropia who underwent bilateral lateral rectus muscle fenestration were prospectively enrolled in this study. Success was defined as postoperative alignment within 8(Delta) of orthotropia in the primary position at the last follow-up.RESULTS A total of 36 children were included. The mean preoperative angle of deviation at distance improved from 33.1(Delta) +/- 3.8(Delta) (range, 25(Delta)-40(Delta)) preoperatively to 4.5(Delta) +/- 5.7(Delta) (range, 0-16(Delta)) postoperatively (P < 0.001). The near angle was reduced from 32.0(Delta) +/- 4.2(Delta) (range, 25(Delta)-35(Delta)) to 2.8(Delta) +/- 4.5(Delta) (range, 0(Delta)-14 (Delta)) postoperatively (P < 0.001). Successful outcome was achieved in 81% of the cases at the 6-month follow-up. There were no reported intra- or postoperative complications.CONCLUSIONS In our study cohort, bilateral fenestration of the lateral rectus muscle resulted in successful outcomes in the majority of patients, resulting in a significant reduction in angle of deviation in primary position at both distance and near fixation.