Intermittent Exotropia: Management Options and Surgical Outcomes

Background: This paper reflects an effort to recreate a modern analysis of a 1985 study on surgical outcomes of intermittent exotropia. Post-surgical results are reported as functional, motor, cosmetic, and unsuccessful. Modern optometric approaches to management of intermittent exotropia are also discussed. Methods: A literature review of 17 acceptable papers (dating from 1990-2011) on the outcome of strabismus surgery for intermittent exotropia was conducted. Search words included: intermittent exotropia, strabismus, strabismus surgery, and strabismus surgical outcomes. Results: No papers exactly fit the rigorous standards of the original 1985 study regarding surgical outcomes for intermittent exotropia. Some modern papers did not differentiate between exo deviations (exophoria versus exotropia) or strabismic deviations (esotropia versus exotropia). Not one study reported an absence of post-surgical strabismus and concomitant functional improvement. However, in papers citing functional results only, 62.3% of patients had successful postsurgical outcomes. Conclusions: Data from the 1985 study on surgical outcomes of intermittent exotropia is impossible to recreate in 2011. Interestingly, more surgeons/authors in modern studies show an interest in post-surgical functional vision than in the 1985 version. Very few modern studies analyze the use of vision therapy concomitantly with strabismus surgery. This is a potential area of future interest.