We assessed the relationship between the surgical outcome of intermittent exotropia and initial postoperative alignment by checking it on the first postoperative day or the day of strabismus surgery.

Seventy-three patients with intermittent exotropia underwent bilateral lateral rectus recession or unilateral medial rectus resection and lateral rectus recession. Thirty-two patients had their postoperative alignment checked on the day of surgery, and forty-one patients were checked on the first postoperative day. Success was defined as sustained alignment six months postoperatively from esotropia 10PD to exotropia 10PD. Overcorrection was defined as esotropia greater than 11PD, and undercorrection was exotropia greater than 11PD. We assessed the relationship between the alignment on the day of surgery or on the first postoperative day and also at six months postoperatively, as well as the success rate according to the initial postoperative alignment.

There was a statistically significant relationship between alignments on the day of surgery or on the first postoperative day and those at six months postoperatively (p<0.001, p<0.001). The deviation on the first postoperative day had a greater correlation coefficient compared to the deviation on the day of the operation (Pearson correlation coefficient=0.704, and 0.593, respectively). The alignment of overcorrection ranged from 11~20PD on the day of surgery, and on the first postoperative day it produced a relatively high success rate (p=0.016, p=0.035). There was no statistically significant difference in the success rate between the two types of surgery (p=0.832).

The alignment on the day of surgery showed a high correlation to the outcome on the sixth postoperative month in intermittent exotropia patients. The initial postoperative overcorrection of 11 to 20PD on the day of surgery and on the first postoperative day resulted in the best long-term outcomes.