Bilateral medial rectus recession in convergence excess esotropia, with and without distance orthophoria

Area of Science:

• Ophthalmology
• Pediatric Ophthalmology
• Strabismus Surgery

Background:

• Acquired convergence excess esotropia is a common condition in children.
• Management options include conservative treatments like bifocals or surgical intervention.
• Bilateral medial rectus recession is a surgical technique used to address esotropia.

Purpose of the Study:

• To evaluate the effectiveness and safety of bilateral medial rectus recession for acquired convergence excess esotropia.
• To assess outcomes in patients with and without distance orthophoria.
• To determine the surgical success rate and complication profile.

Main Methods:

• A retrospective study of 35 pediatric patients with acquired convergence excess esotropia.
• All patients underwent bilateral medial rectus recession based on the near deviation.
• Surgical adjustments were made for distance deviation in some patients, while others had distance orthophoria with full hypermetropic correction.

Main Results:

• Successful alignment was achieved in 73% of patients with distance esotropia and 66.6% of patients with distance orthophoria.
• Consecutive exotropia occurred in 7.6% of the distance esotropia group and 11.1% of the distance orthophoria group.
• The surgery effectively eliminated the near angle in convergence excess esotropia.

Conclusions:

• Bilateral medial rectus recession is an effective surgical treatment for acquired convergence excess esotropia.
• The procedure can be considered an initial treatment option for patients with distance orthophoria, potentially avoiding the need for bifocals.
• While the risk of consecutive exotropia is low, further studies with larger cohorts are needed to precisely determine its incidence.