bilateral medial rectus advancement versus bilateral lateral rectus recession in consecutive exotropia

purpose: to compare bilateral medial rectus advancement (bmra) and bilateral lateral rectus recession (blrr) for treatment of consecutive exotropia in terms of final alignment. method: this randomized clinical trial was performed on 14 patients with consecutive exotropia. inclusion criteria included history of bilateral medial rectus recession, exotropia ³20 pd and far-near difference <10 pd. exclusion criteria included history of operation on the lateral rectus, restriction of adduction, positive forced duction test of the lateral rectus, history of previous medial rectus recession, neurologic disorders and follow-up of less than 6 months. seven patients underwent bmra and 7 patients underwent blrr. results: mean age was 11.4±6.9 (range 5 to 21) years in the bmra group and 13.7±7.1 (range 5-22) years in the blrr group (p=0.44). two patients in the bmra group and 3 in the blrr group were amblyopic. mean preoperative exotropia was 27.8±6.3 pd and 39.2±14.8 pd (p=0.09) and successful alignment was achieved in 71.4% and 85.7% of cases in the bmra and blrr groups, respectively (p=0.94). all patients with amblyopia had successful alignment. conclusion: bilateral medial rectus advancement and bilateral lateral rectus recession are comparable in the management of consecutive exotropia.