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Results of classical and augmented bimedial rectus recession in infantile esotropia
A K Altintas1, G F Yilmaz, S Duman
1Ophthalmology Clinic, Ankara Research and Education Hospital, Ankara, Turkey.
Purpose:
To compare the success rates of augmented bimedial rectus recession and the standard recession.
Materials And Methods:
Ninety patients were included in the study. The patients were evaluated in two groups according to the amount of recession. Group 1, the standard surgery group, received 5 mm or less of recession; Group 2, the augmented surgery group, received 6 mm of recession or more. The mean postoperative follow-up was 29 months (6-60 months) in Group 1, and 20 months (6-58 months) in Group 2.
Results:
The mean age at the time of surgery was 4.61 years in Group 1 and 4.58 years in Group 2. The 56 patients in Group 1 underwent bilateral rectus recession varying from a minimum of 3 mm to a maximum of 5 mm; the 34 patients in Group 2 had recessions varying from a minimum of 6 mm to a maximum of 8 mm. The mean preoperative angle size was 39.64 +/- 8.93 SD (range 20-50 PD) in the standard surgery group, and 59.70 +/- 10. 04 SD (range 51-85 PD) in the augmented surgery group. The average postoperative deviation was 13.37 +/- 11.87 SD (range 0-45) in Group 1 and 9.02 +/- 10.02 (range 0-45) in Group 2. A good surgical result was achieved with one operation in 29 of 56 patients (51.8%) in Group 1 and 24 of 34 patients (70.58%) in Group 2.
Discussion:
The optimal surgical technique for the correction of large-angle esotropia is still controversial; it appears that the augmented bilateral medial rectus recession is an effective and reasonable alternative to three- or four-muscle procedures as the initial surgical treatment.
