Would you use 67312 X2?
Exotropia of 35 to 40 prism diopters with overacting inferior obliques that exhibits a V pattern.

Bilateral lateral rectus recession, 8.0 mm.
Bilateral inferior oblique myectomy.

Attention was first directed towards the left eye and episcleral fixation suture of 4-0 silk was placed at the limbus infratemporally and the eye was rotated supranasally. The conjunctiva and Tenon capsule was then incised approximately 10 mm posterior to the limbus and this tissue plane was carried down to the level of the sclera. Two Stevens muscle hooks were used to isolate the inferior oblique muscle. Two hemostats were placed on either side of the Stevens muscle hook and the muscle was transected. The cautery was applied to the ends of the hemostat and the muscle was released. No bleeding occurred. The conjunctiva was closed using interrupted 6-0 chromic suture.

Attention was then directed towards the lateral rectus where episcleral fixation sutures were placed at 3 o’clock and 9 o’clock and the eye was rotated nasally. The conjunctivae and Tenon’s capsule was incised and this tissue plane was carried down to the level of the lateral rectus muscle. The check ligaments were incised.

Using a double-arm 6-0 Vicryl suture in cut in half, the superior and inferior poles of the muscle were tied and the muscle was disinserted from the globe and recessed 8 mm by passing the sutures through the sclera. The muscle was noted to be in good position.

Thanks in advance!!