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Cohort studyThe Journal of international medical research · 2026

V-pattern and accommodative convergence/accommodation ratio in consecutive esotropia after surgery for intermittent exotropia: A comparison of bilateral lateral rectus recession and unilateral recession-resection.

Liping Chen, Yuehe Xu, Xia Sheng … Wei Zhang

OphthalmologyCohort study

V-pattern was more common after bilateral than unilateral squint surgery when esotropia recurred.

V-pattern and accommodative convergence/accommodation ratio in consecutive esotropia after surgery for intermittent exotropia: A comparison of bilateral lateral rectus recession and unilateral recession-resection.

Liping Chen … Wei Zhang

The Journal of international medical research · 2026

Purpose

To delineate a clinically actionable phenotype of consecutive esotropia with V-pattern following surgery for intermittent exotropia and to determine whether the initial surgical approach-bilateral lateral rectus recession versus unilateral recession-resection-is associated with differential patterns of V-pattern presentation and accommodative convergence/accommodation behavior among patients who develop consecutive esotropia.

Methods

We retrospectively reviewed patients who developed consecutive esotropia after surgery for intermittent exotropia and were evaluated/managed at our center between 2016 and 2024.

Results

V-pattern far more common after bilateral surgery

15patien

Bilateral lateral rect

3patien

Recession-resection (n

More results

Baseline distance exodeviation was comparable between groups (bilateral lateral rectus recession: 38.92 ± 12.78 Δ at 6 m and 36.47 ± 13.47 Δ at 33 cm; recession-resection: 39.04 ± 12.91 Δ at 6 m and 40.60 ± 10.54 Δ at 33 cm), whereas near exodeviation was greater in the recession-resection group than in the bilateral lateral rectus recession group.

More results

No patient demonstrated a preoperative pattern deviation.

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Conclusion

Among patients who developed consecutive esotropia after intermittent exotropia surgery, bilateral lateral rectus recession-derived consecutive esotropia was more commonly accompanied by V-pattern and a higher accommodative convergence/accommodation ratio than recession-resection-derived consecutive esotropia.

Post

V-pattern and accommodative convergence/accommodation ratio in consecutive esotropia after surgery for intermittent exotropia: A comparison of bilateral lateral rectus recession and unilateral recession-resection.

V-pattern was more common after bilateral than unilateral squint surgery when esotropia recurred.

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