AIM: To observe the clinical curative effect of surgical correction of concomitant exotropia combined with weakening procedures in the treatment of children with complex strabismus.

METHODS: Totally 68 children(80 eyes)with complex strabismus who were admitted to the hospital from January 2015 to February 2017 were selected. All of them were treated by surgical correction of concomitant exotropia. The clinical diagnosis and treatment were retrospectively analyzed. They were divided into the combined group(n=30, 35 eyes)and the non-combined group(n=38, 45 eyes)according to the implementation of inferior oblique weakening procedures. The visual function, 5m exotropia deviation, degree of inferior oblique muscle overreaction and results of Titmus stereoscopic experiment were compared between the two groups before and after surgery. The postoperative curative effect of both groups was observed.

RESULTS: The proportions of patients with simultaneous vision, patients with certain fusion range, patients with distant stereoscopic vision and normal patients with near stereoscopic vision(40-60s)in both groups were significantly increased surgery at 6mo after surgery(P<0.05), without significant differences between groups(P>0.05). The degree of inferior oblique muscle overreaction and 5m exotropia deviation in both groups were significantly improved at 6mo after surgery(P<0.05), but there was no significant difference between groups(P>0.05). Follow-up of 1-3d, 1a after operation showed there were no significant differences between the two groups in the orthophoria rate, over-correction rate or under-correction rate(P>0.05).

CONCLUSION: In the treatment of children with complex strabismus by surgical correction of concomitant exotropia, the combined use of inferior oblique weakening procedures may not affect the correction effects of exotropia. When the surgery is designed, the impact of inferior oblique weakening procedures can be ignored.