Clinical Analysis of Large Recession of Bimedial Rectus Muscles in Esotropia

ABSTRACT

Nineteen patients with large angle esotropia who have undergone bimedial rectus recession ranging from 7 to 8 millimeters were evaluated. We retrospectively reviewed preoperative and postoperative visual acuity, deviation, ocular motility, fusion, stereoacuity in all patients. The mean preoperative deviation was 76 prism diopters, ranging from 65 to 95 prism diopters and the mean postoperative follow up interval was 55.6 months, ranging from 26 to 80 months. The overall successful rate(horizontal orthotropia within+/-10 prism diopters) was 42.1%(8/19). The rate of undercorrection was 47.7%(9/19) and the rate of delayed consecutive exotropia was 10.5%(2/19). Fusion at near was found in 36.8%(7/19) and stereopsos of 200 seconds or better was found in 15.8%(3/19) of patients postoperatively.We observed no limitation of adduction or convergence. If reoperation was necessary, there still remain other untouched horizontal muscles on which to operate.Therefore, 7 to 8 millimeter medical rectus recession is the first effective procedure for the correction of large angle esotropia with deviations of more than 65 prism diopters.