Adjustable medial rectus muscle resection in adult exotropia

Purpose: To describe the success of a unilateral recess/resect procedure incorporating an adjustable medial rectus muscle resection in the treatment of adult exotropia. Methods: The charts of 60 consecutive adult patients with exotropia undergoing lateral rectus muscle recession and adjustable medial rectus muscle resection from November 1998 to August 2003 were reviewed. Results: In 56 (93%) patients, postoperative alignment was within 10 prism diopters of orthophoria. Using adjustable suture technique, a small esodeviation was consistently created in the field of gaze away from the resected medial rectus muscle, and this may guard against recurrence of exotropia. Conclusions: The use of adjustable medial rectus muscle resection is an alternative, successful, and reliable procedure for the management of adult exotropia.