Results of large single medial rectus recession

Fifty-three patients with esotropia of 14 to 20 prism diopters received a 6-mm recession of one medial rectus muscle. All patients were three to ten years of age, had normal, equal vision, no vertical muscle imbalance, normal neurological status, and were followed for a minimum of two years. Twenty patients had high AC/A ratios, 22 were partially accommodative, four were deteriorated esophorias, four were anisometropes, and three were second operations. The average correction measured 16 prism diopters, ranging from 13 to 22 prism diopters, and 37 patients were aligned to 4 prism diopters or less of strabismus, 10 were microtropes, and all 53 had less than 10 prism diopters deviation. No persistent diplopia or consecutive exotropia was encountered. Stereopsis of 200 seconds or better was found in 75% of patients postoperatively. Large single medial rectus recessions appear to be a safe, effective, and predictable means of restoring ocular alignment and binocular vision in a select group of patients.