Medial Rectus Bridge Faden Operations in Accommodative and Partially Accommodative Esotropia With Convergence Excess

To evaluate the results of the bilateral bridge Faden operation on the medial rectus muscles with and without recession in the treatment of accommodative and partially accommodative esotropia with convergence excess.

A retrospective analysis was performed on the medical records of 103 patients who underwent the bridge Faden operation on both medial rectus muscles, with or without recession, for the treatment of accommodative and partially accommodative esotropia with convergence excess. Preoperative and postoperative near and distance deviations and near-distance disparities were evaluated.

The study population consisted of 38 (37%) girls and 65 (63%) boys. The mean age was 9.32 ± 5.83 years (range: 1 to 18 years) and the mean follow-up period was 14.49 ± 2.78 months. Fifty-one patients underwent the bridge Faden operation on both medial rectus muscles with recession (recession group) and 52 patients underwent the bridge Faden operation on both medial rectus muscles without recession (no recession group). The mean preoperative amount of esotropia at near was 43.51 ± 7.00 and 24.24 ± 3.56 prism diopters (PD) for the recession and no recession groups, respectively. The mean preoperative amount of esotropia at distance was 26.63 ± 6.86 and 9.22 ± 2.09 PD for both groups, respectively. The mean preoperative near-distance disparity was 17.14 ± 3.00 and 14.05 ± 4.14 PD for both groups, respectively. In both groups, there was a statistically significant difference in the near and distance deviations and the near-distance disparity between preoperative and postoperative values (P < .05). Postoperatively, there was no significant difference between 1 month, 6 months, and 1 year and between 6 months and 1 year (P > .05).

The bridge Faden operation on both medial rectus muscles either with or without recession was a successful surgical procedure in patients with accommodative and partially accommodative esotropia. During the follow-up period, the success rates did not decrease. [J Pediatr Ophthalmol Strabismus. 2017;54(6):369-374.].