ABSTRACT
PURPOSE: The surgical results for exotropia with convergence insufficiency have been reported to be unsatisfactory and there was a risk of creating diplopia due to postoperative esotropia at distance. The purpose of this study is to determine the effective surgical method in convergence insufficiency exotropia. METHODS: Two surgical procedures were alternately performed in patients with convergence insufficiency exotropia. Minimum follow-up was 6 months after surgery. In the bimedial resection (BMR) group (n=9), bilateral medial recti (MR) resections were performed with slanted procedure where the upper MR margin was resected to correct the distance deviation and the lower margin was resected to correct the near deviation. The recession and resection (R and R) group (n=15) involved MR resection and lateral rectus recession where the amounts of resection and recession were based on the near and distance deviation, respectively. RESULTS: At an average last follow-up of 22 months, a significant reduction in the distance and near angle of deviation, as well as in the difference between the distance and near deviation, was shown in the R and R group as compared with the BMR group (p<0.05). Fresnel prism was used to treat postoperative diplopia in only one patient of the R and R group. CONCLUSIONS: The surgical method of the R and R group appeared to produce a more favorable result than that of the BMR group without the risk of long-term postoperative diplopia at distance in convergence insufficiency exotropia.