Comparison of Functional Equator-Considering and Parks Methods in Bilateral Medial Rectus Recession for Esotropia

PURPOSE: To compare the surgical outcomes of functional equator-considering and Parks' methods in infantile esotropia and partially accommodative esotropia. METHODS: The medical records of 96 patients with infantile esotropia and partially accommodative esotropia who underwent bilateral medial rectus muscle recession by functional equator-considering and Parks' methods were reviewed retrospectively. The surgery success rate at 1 month, 3 months, 6 months and 12 months was compared by the deviation angle measurement. RESULTS: Overall success rates were not statistically different between the 2 groups. Additionally, there were no differences in surgical success rate of functional equator-considering and Parks' methods in infantile esotropia and partially accommodative esotropia. When the patients were divided into 2 groups based on 40 PD, no significant difference in success rate between the 2 groups was observed. When patients were divided into 2 groups based on 22 mm of axial length, there was no statistical difference observed. Postoperative overcorrection was 2 (4%) in the functional equator group and 3 (6.5%) in Parks' method group and postoperative undercorrection was 9 (18%, 19.6%) in each group. The incidence of undercorrection in the Parks' method group was significantly higher in the greater than 22 mm axial length group (7, 35.0%) than in the less than 22 mm group (2, 7.7%) (p = 0.029). CONCLUSIONS: There was no statistically significant difference in surgical success rate between the functional equator and Parks' methods in infantile esotropia and partially accommodative esotropia.

Bilateral Medial Rectus Recession Posterior to the Functional Equator in Esotropia Over 40 Prism Diopters

PURPOSE: To investigate bilateral medial rectus recession by considering functional equator as a surgical guideline in esotropia over 40 prism diopters (PD). METHODS: Forty-one patients who underwent bilateral medial rectus recession, and were followed-up for more than 12 months, were reviewed. The success rate was compared between group 1 and group 2, which were divided to recession site from the functional equator posterior, and also between the hyperopia group and myopia group according to refraction. RESULTS: According to preoperative deviation angle, 21 patients underwent recession to less than 10 mm posterior to the functional equator (group 1) and 20 patients had recession to 1.5 mm to 2.0 mm posterior to the functional equator (group 2). No significant difference in success rate between group 1 (71.4%) and group 2 (75.0%) was detected at the last follow-up. When divided into a hyperopia group (26 patients) and myopia group (15 patients), the success rate in the myopia group was higher than in the hyperopia group, as observed at the last follow-up, but the difference was not significant. There was 1 case of overcorrection in each group. CONCLUSIONS: A successful outcome was achieved in 30 patients (73.2%), and overcorrection in 2 patients (4.9%) when recessed to 2.0 mm posterior to functional posterior in esotropia over 40PD.

Surgical Outcome of Esotropia Considering the Functional Equator

PURPOSE: To predict the surgical outcome of esotropia by considering the axial length of the functional equator in addition to the preoperative deviation angle. METHODS: Forty patients with partially accommodative esotropia or infantile esotropia who had received bilateral medial rectus muscle recession were studied for axial length of the functional equator in addition to the preoperative near deviation angle. Patients were followed for more than 12 months. All patients were checked for near and far deviation angles at postoperative 1 week, 1 month, 6 months and 12 months. RESULTS Seventeen of the 40 patients had partially accommodative esotropia and 23 had infantile esotropia. The overall mean age was 4.1 years and the mean follow-up period was 14.1 months (12-18 months). Preoperative near and far deviation angles were respectively 30.6+/-8.1PD and 25.6+/-12.2PD in partially accommodative esotropia patients and 44.9+/-11.7PD and 43.1+/-13.5PD in infantile esotropia patients. The amount of mean medial rectus muscle recession was 5.15+/-0.87 mm in the former group and 6.26+/-1.12 mm in the latter. At the postoperative 12-month follow-up, 20 (86.9%) partially accommodative esotropia patients showed successful outcomes and 3 (13.1%) had under correction; the outcome was successful in 15 (88.2%) infantile esotropia patients while 2 (11.8%) showed under correction. CONCLUSIONS: A successful outcome was achieved in patients with partially accommodative esotropia and infantile esotropia with consideration of the functional equator.

Surgical Outcome of Esotropia Considering the Functional Equator

PURPOSE: To predict the surgical outcome of esotropia by considering the axial length of the functional equator in addition to the preoperative deviation angle. METHODS: Forty patients with partially accommodative esotropia or infantile esotropia who had received bilateral medial rectus muscle recession were studied for axial length of the functional equator in addition to the preoperative near deviation angle. Patients were followed for more than 12 months. All patients were checked for near and far deviation angles at postoperative 1 week, 1 month, 6 months and 12 months. RESULTS Seventeen of the 40 patients had partially accommodative esotropia and 23 had infantile esotropia. The overall mean age was 4.1 years and the mean follow-up period was 14.1 months (12-18 months). Preoperative near and far deviation angles were respectively 30.6+/-8.1PD and 25.6+/-12.2PD in partially accommodative esotropia patients and 44.9+/-11.7PD and 43.1+/-13.5PD in infantile esotropia patients. The amount of mean medial rectus muscle recession was 5.15+/-0.87 mm in the former group and 6.26+/-1.12 mm in the latter. At the postoperative 12-month follow-up, 20 (86.9%) partially accommodative esotropia patients showed successful outcomes and 3 (13.1%) had under correction; the outcome was successful in 15 (88.2%) infantile esotropia patients while 2 (11.8%) showed under correction. CONCLUSIONS: A successful outcome was achieved in patients with partially accommodative esotropia and infantile esotropia with consideration of the functional equator.