This retrospective chart review evaluated surgical outcomes of the Scott 2:1 same-muscle recession-resection technique in 35 patients with incomitant strabismus (≥5Δ difference between primary and diplopic gazes) over a 10-year period (January 2014–August 2024) at a single tertiary center.
Preoperative incomitance improved from 9.5Δ ± 6Δ to 1Δ ± 2Δ (P < 0.0001) in 34 of 35 patients (97%), with comparable results across all rectus muscles and across small vs. large incomitance groups; 12.5% required reoperation.
- Single-surgeon, single-center retrospective design limits generalizability. - Small sample size (n=35) reduces statistical power to detect subgroup differences. - No control group or comparison to alternative surgical dosing strategies.
The Scott 2:1 recession-resection ratio is an effective, adjustable technique for incomitant strabismus regardless of which rectus muscle is involved or whether the patient has had prior strabismus surgery. A reoperation rate of ~12.5% should be discussed during preoperative counseling.
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