Three and Four Horizontal Muscle Surgery for Large Angle Exotropia

Surgery on two horizontal recti typically is most effective for angles less than 40 prism diopters (PD). The authors evaluate their experience operating on three or four rectus muscles for angles exceeding 40 PD.Retrospective chart review of 47 patients who underwent a first surgical procedure for a large angle comitant exodeviation. Patients were observed for a minimum of 2 months. Success was defined as deviation ±10 PD.Median age was 48 years...