Surgery for residual convergence excess esotropia.

Area of Science:

• Ophthalmology
• Strabismus Surgery
• Pediatric Ophthalmology

Background:

• Convergence excess esotropia is a common strabismus type.
• Residual esotropia after initial surgery often requires further intervention.
• Medial rectus posterior fixation sutures are a surgical option for managing esotropia.

Purpose of the Study:

• To evaluate the efficacy of bilateral medial rectus posterior fixation sutures with or without central tenotomy as a secondary surgical procedure.
• To assess the impact of this procedure on near angle deviation and stereopsis.
• To determine the need for bifocals post-surgery.

Main Methods:

• A retrospective analysis of 11 patients with residual convergence excess esotropia.
• Patients underwent secondary surgery including bilateral medial rectus posterior fixation sutures +/- central tenotomy.
• Preoperative and postoperative near angle measurements and stereopsis were recorded.

Main Results:

• Postoperative near angle improved significantly, with a mean of 12 prism diopters (range 4-30 PD) compared to a preoperative mean of 30 PD (range 16-45 PD).
• Nine out of 11 patients showed improved stereopsis postoperatively.
• The need for bifocals was eliminated in patients who demonstrated improved stereopsis.

Conclusions:

• Bilateral medial rectus posterior fixation sutures with or without central tenotomy represent a viable secondary surgical approach.
• The procedure effectively reduces esotropic deviation and enhances binocular function.
• This surgical technique can lead to improved visual outcomes and reduced dependence on corrective lenses.