Unilateral versus bilateral medial rectus recession

Area of Science:

• Ophthalmology
• Pediatric Surgery
• Strabismus Surgery

Background:

• Unilateral medial rectus recession is a surgical option for small-angle esotropia.
• This approach involves operating on one eye, potentially reducing surgical time and complexity.
• Comparison with bilateral surgery is essential for understanding efficacy.

Purpose of the Study:

• To compare the outcomes of unilateral and bilateral medial rectus recessions.
• To evaluate the predictability of unilateral medial rectus recession for pediatric esotropia.
• To determine the change in deviation per millimeter of recession for both surgical approaches.

Main Methods:

• Retrospective analysis of pediatric patients undergoing medial rectus recession (unilateral or bilateral).
• Data collected from August 1995 to March 2002 by a single surgeon.
• Postoperative deviations assessed at short-term (2-8 weeks) and long-term (6-48 months) follow-up.

Main Results:

• 80% of unilateral (45 patients) and 80% of bilateral (41 patients) cases were analyzed.
• Long-term follow-up showed mean deviation changes per millimeter for unilateral recessions ranged from 2.2 to 2.5 PD/mm.
• Equivalent bilateral recessions resulted in significantly higher mean deviation changes, ranging from 4.0 to 5.0 PD/mm.

Conclusions:

• Unilateral medial rectus recession is a predictable surgical method for pediatric small-angle esotropia.
• The efficacy (change in deviation per millimeter) of unilateral recession is significantly less than bilateral recession.
• This suggests tailored surgical approaches based on deviation magnitude.