Medial Rectus Disinsertion for the Management of Large-Angle Sensory Esotropia

Area of Science:

• Ophthalmology
• Strabismus Surgery

Background:

• Large-angle esotropia (ET) presents significant management challenges.
• Medial rectus (MR) disinsertion is an uncommon surgical approach for ET.

Purpose of the Study:

• To evaluate the outcomes of medial rectus (MR) disinsertion in patients with large-angle esotropia (ET).

Main Methods:

• Retrospective case series of five patients undergoing accidental MR disinsertion during muscle surgery.
• Data collected included pre- and postoperative ET angles, duction limitations, and follow-up duration.

Main Results:

• Preoperative ET averaged 92.0 PD, reducing to 38.0 PD post-MR disinsertion.
• Abduction deficiency improved from -4 to -1 postoperatively.
• Mean follow-up was 24.8 months in patients aged 62.2 years.

Conclusions:

• Medial rectus (MR) disinsertion yielded less frustrating outcomes than anticipated for large-angle esotropia (ET).
• This procedure could be considered for specific cases of large-angle sensory ET, particularly when contraindications for other surgeries exist.