Results of unilateral medial rectus recession in high AC/A ratio esotropia

Twenty-five patients with high accommodative convergence/accommodation (AC/A) ratios and near esotropia of 15 to 35 prism diopters were treated with a 6- to 8-mm unilateral medial rectus recession according to the near deviation. In 24 patients (96%), the esodeviation was aligned within 10 delta, with a follow up ranging from 3 to 7 years. Only one patient had greater than 10 delta of esotropia (14 delta), and none became exotropic. This procedure appears to be a safe and effective method in the treatment of esotropia with high AC/A ratios, in a selected group of patients.