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Lateral rectus advancement versus medial rectus recession for consecutive esotropia
Masoud Aghsaei Fard1, Hossein Ghahvehchian1
1Farabi Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
European Journal of Ophthalmology
|August 15, 2019
Summary
Lateral rectus advancement surgery improved consecutive esotropia more effectively than medial rectus recession surgery in patients without abduction limitation. This surgical approach demonstrated a higher success rate and lower undercorrection rate.
Area of Science:
- Ophthalmology
- Strabismus Surgery
- Pediatric Ophthalmology
Background:
- Consecutive esotropia can develop after surgical correction of intermittent exotropia.
- Treatment options for consecutive esotropia include reoperation on extraocular muscles.
Purpose of the Study:
- To compare the efficacy of lateral rectus advancement versus medial rectus recession for treating consecutive esotropia.
- To evaluate surgical outcomes based on postoperative alignment and need for further intervention.
Main Methods:
- Retrospective review of 43 patients with consecutive esotropia post-bilateral lateral rectus recession.
- Comparison of outcomes between 22 patients undergoing lateral rectus advancement and 21 patients undergoing medial rectus recession.
- Success defined as postoperative phoria/tropia within 8 PD, not requiring a third surgery.
Main Results:
- Lateral rectus advancement achieved a 90.9% success rate, with a mean postoperative deviation of 5.4 ± 3.4 PD esophoria and 6.5 ± 5 PD exophoria/tropia.
- Medial rectus recession had a 71.4% success rate, with a mean postoperative deviation of 9.5 ± 5.0 PD esotropia/phoria and 5.2 ± 1.3 PD exophoria.
- The undercorrection rate was significantly lower in the lateral rectus advancement group (4.5%) compared to the medial rectus recession group (28.6%).
Conclusions:
- Advancement of the previously recessed lateral rectus muscle is a more effective surgical treatment for consecutive esotropia.
- This technique offers a higher success rate and reduced risk of undercorrection compared to medial rectus recession.
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