Dose-Response of Primary Bilateral Medial Rectus Resection in Infantile Exotropia

Lucas B. Farias, Rasha Barham, Ana Luiza Costa, Serena Wang, David R. Weakley

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


PURPOSE: To evaluate the dose-response relationship for primary bilateral medial rectus resection in children with exotropia, based on outcomes with this procedure. METHODS: Dose-response at both distance and near were calculated as prism diopters correction per millimeter (PD/mm) of rectus resection. All surgeries were performed under general anesthesia through a fornix incision, using doubled-armed 6-0 polyglactin sutures. The resection amount ranged from 5 to 8 mm in each eye, according to the surgical dosage based on the largest angle of preoperative deviation. RESULTS: The mean surgical dose-response for all procedures was 2.83 ± 1.03 PD/mm of resection at distance and near. The overall success rate was 53% at the final examination after a mean follow-up of 21.9 months. Patients with moderate angles (25 to 45 PD) had a higher success rate than those with 50 PD or greater deviation. CONCLUSIONS: Primary bilateral medial rectus resection should be considered as a surgical alternative in childhood exotropia, particularly for moderate and constant deviations. [J Pediatr Ophthalmol Strabismus. 2022;59(1):24-27.].

Original languageEnglish (US)
Pages (from-to)24-27
Number of pages4
JournalJournal of pediatric ophthalmology and strabismus
Issue number1
StatePublished - Jan 1 2022

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Ophthalmology


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