PURPOSE To describe characteristics of recurrent intermittent exotropia after bilateral lateral rectus (BLR) recession, and identify factors associated with poor outcome after unilateral medial rectus (MR) resection for recurrent intermittent exotropia. METHODS We retrospectively reviewed 124 patients who have undergone unilateral MR resection for recurrent intermittent exotropia after BLR recession. Patients were followed for at least 2 years after MR resection. Clinical characteristics and risk factors associated with poor outcome after unilateral MR resection were evaluated. Successful outcome was defined as distant deviation within the range of 4 prism diopters (PD) esotropia and 10 PD exotropia at last visit after MR resection. RESULTS Among 124 patients, 50 patients (41.1%) were male, and the mean age at the time of MR resection was 9.5 ± 3.1 years. The average follow-up period after MR resection was 43.8 ± 23.7 months. Forty-seven patients (37.9%) were classified to have poor outcome at last visit, and 29 patients (23.4%) underwent third operation. None of the patients was overcorrected after MR resection. Multiple logistic regression analyses showed that distant deviation at post-operative 3 months and male gender were associated with poor outcome (OR 1.49; 95% CI 1.27-1.73; P < 0.001, and OR 5.19; 95% CI 1.42-18.98; P = 0.013, respectively). CONCLUSION Ocular deviation at 3 months after unilateral MR resection for recurrent intermittent exotropia may play a valuable role in anticipating poor outcome. Patients whose exotropia exceeded 9 PD at distance at 3 months' follow-up tended to recur while those whose exotropia remained below 9 PD at distance showed a stable disease course.

中文翻译：

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复发性间歇性外斜视的内侧直肌切除术后不良预后的危险因素。

目的描述双侧外侧直肌（BLR）退缩后反复间歇性外斜视的特征，并确定单侧内侧直肌（MR）切除后复发性间歇性外斜视的不良预后相关因素。方法我们回顾性回顾了124例行BLR衰退后单侧MR切除术的复发性间歇性外斜视患者。MR切除后至少随访2年。评价了单侧MR切除后不良预后的临床特征和危险因素。成功的结果定义为在MR切除后的最后一次访视时，在4个棱镜屈光度（PD）内斜视和10个PD外斜视范围内的远距偏差。结果124例患者中，有50例（41.1％）为男性，MR切除时的平均年龄为9岁。5±3.1年。MR切除后的平均随访时间为43.8±23.7个月。47例患者（37.9％）被归类为最后一次访视的结果较差，而29例患者（23.4％）进行了第三次手术。MR切除后没有患者矫正过度。多项逻辑回归分析表明，术后3个月的远距离偏离和男性性别与预后差相关（OR 1.49； 95％CI 1.27-1.73； P <0.001，OR 5.19； 95％CI 1.42-18.98； P = 0.013）。结论单侧MR切除术后3个月的眼球偏斜对于复发性间歇性外斜视可能在预测不良预后中起重要作用。在3个月的距离内远视力超过9 PD的患者