AIM:To evaluate the effect of monocular rectus surgery for adult sensory exotropia.

METHODS: Totally 76 cases of adult sensory exotropia of degree -15^△ to -160^△(-68.36^△±30.77^△)examined through Krimsky method were included into this study. A total of 16 cases, 37 cases and 23 cases with different degrees of strabismus were treated separately with routine amount monocular lateral rectus recession, routine amount monocular medial rectus resection plus lateral rectus recession, and exceed constant amount monocular medial rectus resection plus lateral rectus recession. Follow-up was performed at 1d, 1wk, 1, 3 and 6mo after operation. The eye position, monocular movement, intraocular pressure(IOP), slit lamp, and fundus of these patients were examined.

RESULTS:After surgery, 67 cases(88%)were positive and 9 cases(12%)were undercorrection. The postoperative intraocular pressure of operative eye at 1wk was equal to preoperative(P=0.090), and IOP decreased to a valley value at 1mo(P<0.01), there was no significant difference in intraocular pressure between 3mo and 1mo(P=0.092), and no significant difference in intraocular pressure between 6mo and 3mo(P=0.123). And 2 cases(3%)had inflammatory reaction induced by anterior segment ischemia at 1d and 1wk postoperative visits, and they recovered at 1mo follow-up visit; 4 cases(5%)experienced an external dysfunction at the 1, 3 and 6mo follow-up.

CONCLUSION:Monocular rectus surgery has a good therapeutic effect on adult patients with sensory exotropia; the decrease in intraocular pressure secondary to the detached rectus is worth the attention of the surgeon; the incidence of complications after detaching monocular of two rectus muscles is comparable low. Exceed constant amount rectus strabismus surgery for sensory exotropia may result in limited function of postoperative ocular hyperextension.