الفهرس 
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Abstract
The aim of this work is to compare efficacy of bilateral lateral rectus recession surgery versus bilateral lateral rectus recession plus one medial rectus resection surgery in management of exotropia. For this purpose, we study 40 patients with exotropia. They were classified into two equal groups according to the type of surgical technique used; group (1) included 20 patients undergone bilateral lateral rectus recession surgery and group (2) included 20 patients undergone bilateral lateral rectus recession plus one medial rectus resection surgery in management of exotropia. The patients in both groups were age and sex matched (45% males and 55% females in both groups), the mean age was 8.3 ± 2.03 and 8.7 ± 1.46 years in group (1) and (2), respectively. P value was statistically insignificant (P >0.05) between the two groups.
The mean preoperative angle of deviation was 44.75 ± 2.85 (range: 40-50 PD) in group (1) and 46.75 ± 3.25 (range: 40-50 PD) in group (2) in both distant and near. There is no statistical difference between them (P >0.05). Patching test, distant and near tests showed mean of 45.75 ± 3.40 and 48.25 ± 2.275 in group (1) and (2), respectively. P value was statistically insignificant (P >0.05) between the two groups.
In the current study, there is no change in preoperative and post-operative visual acuity in both studied groups, statistically there is no significant difference between preoperative and postoperative best corrected visual acuity in both groups (P >0.05).
The outcome of surgery after the end of the follow-up period (6 months) was recorded as follows: 14 patients (70%) and 11 patients (55%) were corrected in groups (1) and (2), respectively, 1 patient (5%) and 8 patients (40%) were overcorrected in groups (1) and (2), respectively, while 5 patients (25%) and 1 patient (5%) were under-corrected in groups (1) and (2), respectively. They showed a statistically highly significant difference between group 1 and group 2 (p <0.001).
The overall success of strabismus surgery was 70% in group (1), lower than group 2 (80%). There was a statistically highly significant of success rate in three-muscle surgery than the two-muscle surgery in the present study. On the other hand, poor outcome was found in 40% of the two-muscle group (1) and 70% of the three-muscle group (2). Comparison of both groups showed a statistically highly significant difference (P <0.001).