AIM: To investigate the potential mechanisms of A-V pattern and evaluate the surgical outcomes used in the treatment of sensory exotropia. METHODS: The medical records of patients with sensory A-V pattern exotropia who underwent strabismus surgery between May 2014 to June 2019 was retrospectively reviewed. The control group included sensory exotropia patients without A-V pattern and concomitant A-V pattern exotropia patients with normal vision who undergone strabismus surgery over this same time period. Ocular alignment, best corrected visual acuity, oblique muscle function, and stereopsis records were collected. RESULTS: Among the 843 eligible patients, 91 (10.79%
39 males and 52 females) had A-pattern (54, 6.4%) or V-pattern (37, 4.4%). Age at onset of vision impairment was 4±5y and at the time of surgery was 25±9y. Statistically significant negative correlations were present between impaired visual acuity and the pre-operative exodeviation ( CONCLUSION: The prevalence of sensory A-V pattern exotropia in our study is 10.79%. Visual acuity represents an important factor contributing to the occurrence and development of A-V pattern. Isolated horizontal rectus surgery can provide a good option for the correction of sensory A-V pattern exotropia.