To determine the incidence and related risk factors of reoperation among patients with infantile exotropia who were operated at Imam Hossein Medical Center, Tehran, Iran from 2001 to 2015.

In this descriptive study, 82 infantile exotropic children (F:55/M:27) were divided into two groups with at least 3 months follow up: children with deviation≤10PD (n=64; success group) and those with deviation>10PD (n=18; failure group). Patients with deviation≥20PD were indicated for reoperation. Factors including surgical age, preoperative deviation angle and factors like inferior oblique overaction, dissociated vertical deviation, A-V pattern relating to reoperation were studied. Sensory status was evaluated by Worth 4-dot and Titmus tests.

Reoperation was indicated in 18.30% (n=15) after 11.50±19 months follow up. Preoperative deviation angle and surgical approach were statistically different between two groups (PExodeviation<0.001, POperation Type=0.017). Most of patients (71%) achieved fusion and gross stereopsis (<3000sec/arc), post-operatively.

18.30% of patients needed reoperation especially those with more preoperative exotropia to achieve good alignment. Although recession-resection method had better motor results, we could not suggest it as a first operation for all patients, since it only was performed on amblyopic patients. Gross stereopsis and binocular fusion were seen in the most of patients with age of ≥5 years old.