To evaluate the surgical outcomes of unilateral lateral rectus (LR) recession on the contralateral eye for recurrent intermittent exotropia after unilateral recession-resection (R & R).

A retrospective analysis of 43 patients was performed. The patients were classified into 2 groups, 18 patients who underwent unilateral LR recession for intermittent exotropia of 18 to 20 prism diopters (PD) after unilateral R & R (reoperation group) and 25 patients who had primary unilateral LR recession (primary operation group).

Significant differences in age, gender, refractive error, preoperative deviation, and near stereoacuity were not observed between the 2 groups ( p > 0.05). The mean follow-up duration was 14.28 ± 14.98 months in the reoperation group and 14.68 ± 12.15 months in the primary operation group. Postoperative deviations were 1.11 ± 3.89 PD at near distance and 2.00 ± 4.70 PD at far distance in the reoperation group and 6.44 ± 5.26 PD at near distance and 7.00 ± 5.77 PD at far distance in the primary operation group on the final follow-up ( p = 0.000, p = 0.004). The final surgical successful rates were 94.4% in the reoperation group and 64.0% in the primary group ( p = 0.021).

The long-term surgical results of unilateral LR recession on the contralateral eye was better in patients with recurrent intermittent exotropia of 18 to 20 PD after unilateral R & R than patients who had primary unilateral LR recession.