To investigate the clinical course of recess-resection (R & R) on the contralateral eye for recurrent intermittent exotropia after previous unilateral R & R surgery.

A retrospective analysis was conducted on patients who had unilateral R & R surgery and patients who had a second R & R surgery on the contralateral eye for recurrent intermittent exotropia with at least 12 months of postoperative follow-up.

Our study included 490 patients with unilateral R & R and 119 patients with contralateral R & R. Recurrence was defined as an ocular misalignment of greater than 11PD during follow-up. Cumulative probabilities of surgical success rates were 42.7% and 66.4%, respectively ( p =0.000).

Exotropia reappeared in recurrent intermittent exotropia after contralateral R & R. However, when considering a long-term prognosis, the cumulative probabilities of surgical success were significantly higher in the second surgery.