[Bilateral Medial Recession for Infantile Esotropia]

Bilateral medial rectus recession (BMR) is a common surgical treatment of infantile esotropia with smaller and larger deviations. The aim of this study is to evaluate the dose-effect relationship and the success of the therapy.

The study is a retrospective, monocentric clinical study with one surgeon and 60 patients with infantile esotropia.

60 patients with infantile esotropia were included, who were treated with BMR using microinvasive technique between April 2012 and September 2015. We evaluated pre- and post-operative data in three follow-ups, at 3, 12 and 36 months. A residual deviation ≤ ± 10 PD (prism dioptres) at 12 month follow-up or a measurable positive binocular vision was defined as a positive outcome.

Age at surgery is 5.2 ± 4.6 (median ± SD). Pre-operative deviations at distance were 41 ± 10.5 PD and for near vision 44 ± 11 PD. Spherical equivalent refractive errors were + 2.25 dpt. Post-operative deviations at distance (n = 58) at 12 month follow-up were 6 ± 9.6 PD and at 36 month follow-up (n = 38) were 4 ± 10.5 PD. The mean reduction in deviation in 12 month follow-up were 3.08 ± 1.20 PD per mm and at 36 months 3.18 ± 1.27 PD. For children ≤ 4 years, the value was 3.93 ± 1.86 PD and for children > 4 years 2.81 ± 0.98 PD. The therapeutic success at 12 month follow-up was 67%. Positive binocular vision was proved post-operative in 62% of patients.

BMR is a long-term and efficient surgical treatment of infantile esotropia. The average dose-effect relationship at 36 month follow-up was 3.1 PD per mm.