title: Bilateral lateral rectus muscle recession with medial rectus pulley fixation for divergence excess intermittent exotropia with high AC/A ratio.
abstract: OBJECTIVE
  To evaluate the efficacy of bilateral rectus muscle recession with medial rectus pulley posterior fixation for patients with intermittent exotropia with high AC/A ratio.
  
  
  METHODS
  This study included consecutive patients with exodeviation ≥10(Δ) greater at distance than at near fixation and with a high AC/A ratio who underwent bilateral lateral rectus muscle recession to eliminate the exotropia at distance and pulley posterior suturing on both medial rectus muscles to prevent consecutive esotropia at near fixation. A successful outcome was defined as near or distance angle of exodeviation ≤8(Δ) and a ≤10(Δ) difference between the two.
  
  
  RESULTS
  A total of 7 patients were enrolled. Of these, 5 (71%) achieved successful results. One patient required bifocal correction for postoperative esodeviation at near fixation.
  
  
  CONCLUSIONS
  In this case series, most patients with intermittent exotropia and a high AC/A ratio were successfully treated with bilateral lateral rectus muscle recession combined with medial rectus pulley posterior fixation.
authors.affiliation: Department of Ophthalmology, Pusan National University Hospital, Busan, Korea.
authors.forename: Hee Young
authors.initials: HY
authors.lastname: Choi
authors.forename: Jae Ho
authors.initials: JH
authors.lastname: Jung
mesh_terms: D000065:Accommodation, Ocular / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D005099:Exotropia / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009801:Oculomotor Muscles / Q000503:physiopathology / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D016896:Treatment Outcome; D015348:Vision, Binocular / Q000502:physiology