Treatment for Convergence Excess Esotropia by Slanted Medial Rectus Muscle Recession

ABSTRACT

To investigate whether the slanted medial rectus recession can correct excess esotropia at near without overcorrection at distance and reduce the distance-near deviation difference, we examined 11 convergence excess esotropia patients who had deviation at near exceeding distance esotropia by 15PD or more, and underwent this operation. They composed of 7 partially accommodative esotropia with high AC/A ratio and 4 nonaccommdodative convergence excess esotropia. The surgical procedure consisted of bilateral, symmetrical slanted recession of the medial rectus muscle. The amount of recession of the upper and lower margins were calculated so as to correct the esotropia with correction at distance, and near respectively. The preoperative mean near and distance deviation were 33.8PD and 15PD, and each decreased to 9.2PD and 4.3PD postoperatively. The preoperative mean distance-near deviation difference were 18.8PD, and decreased to 5.4PD postoperatively. The 3 patients decreased over 10PD in the distancenear deviation difference. In conclusion, the surgical procedure, as bilateral slanted medial rectus recession, can correct excess esotropia at near without overcorrection at distance and reduce the distance-near deviation difference. Therefore, the bilateral slanted medial rectus recession may be used as the method of surgical treatment in convergence excess esotropia.