Question

I have had two previous strabismus surgeries (one at 6 and another at 25 years of age). I still have a significant residual right exotropia. What is the possibility that a third procedure to realign the eyes would be successful? I realize that my stereo vision did not and never will fuse (my wife hates for me to drive because I cannot judge distances very well!) so any procedure will be done solely for cosmetic purposes.

(George L. Garcia MD)

Answer:

Thank you for your question concerning the chance of divergent strabismus returning after an additional third surgery. It is generally said that such chance would be a third after each consecutive operation. However, we did perform a study on the same question in convergent strabismus last year. About 171 patients were questioned 10 years after surgery on whether they were operated again or not. It turned out that the actual recurrence rate was only half of what strabimologists generally think.

This is likely to be caused by an observation bias (you remember the cases that recurred, not the patients that you never saw again after surgery because they were cured). So my guess would be that the chance of you needing a fourth operation would be between a third and a sixth after having a third operation.

(Herb Simonsz, MD, PhD)

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