Abstract:

Secondary exotropia is divided into perceptual exotropia, continuous exotropia, and recurrent exotropia, and its surgical methods are divided into primary, secondary, and above surgeries. Patients with perceptual exotropia who have poor vision in one eye often undergo a single surgery. Patients with small to moderate strabismus may undergo internal rectus muscle shortening combined with external rectus muscle recession, while those with high strabismus may undergo combined with oblique muscle weakening surgery. The secondary surgery for continuous exotropia and recurrent exotropia depends on the initial surgical approach. For patients with unilateral or bilateral recession of the external rectus muscle, unilateral or bilateral shortening of the internal rectus muscle is feasible. For patients with unilateral or bilateral shortening of the inner rectus muscle, unilateral or bilateral recession of the outer rectus muscle can be performed. For patients with unilateral recession of the outer rectus muscle combined with shortening of the inner rectus muscle, the same surgical procedure can be performed on the opposite eye. The success rate of unilateral external rectus recession and internal rectus recession surgery is high. New methods such as internal rectus muscle transfer and scar tissue resection are effective. The improved method of moving the internal rectus muscle forward to 1 mm in front of the original attachment point during surgery is safer. The new surgical approach of lateral orbital incision can handle difficult cases, and the application of preoperative magnetic resonance imaging, pathological examination of scar tissue removal, and intramuscular injection of drugs during surgery are of great benefit to design of surgical methods.

Key words: Secondary exotropia, Sensory exotropia, Ophthalmologic surgical procedures