Surgical outcomes of unilateral medial rectus recession for partially accommodative esotropia

Area of Science:

• Ophthalmology
• Pediatric Ophthalmology
• Strabismus Surgery

Background:

• Partially accommodative esotropia (PAET) is a common form of childhood strabismus.
• Surgical intervention, such as unilateral medial rectus (UMR) recession, is often considered for residual esotropia after conservative management.
• Long-term outcomes of UMR recession in PAET require further investigation.

Purpose of the Study:

• To evaluate the long-term efficacy of unilateral medial rectus (UMR) recession surgery in children with partially accommodative esotropia (PAET).
• To identify factors associated with successful surgical outcomes in this patient cohort.

Main Methods:

• Retrospective review of medical records for 28 children (≤10 years) with PAET and residual esotropia (≤25 PD) post-correction.
• Inclusion criteria: follow-up ≥1 year, successful outcome defined as phoria ≤5 PD.
• Analysis of preoperative deviation, UMR recession amount, age at surgery, and duration of prism glasses wear.

Main Results:

• The mean preoperative esodeviation was 15.5 PD, with a mean UMR recession of 5.6 mm.
• Postoperative follow-up averaged 4.4 years.
• Overall surgical success rate was 53.6%, with a significant decrease in mean esodeviation to 6.2 PD.
• Success was associated with older age at surgery, longer prism glasses use, and greater UMR recession amount.

Conclusions:

• Unilateral medial rectus recession achieves successful long-term outcomes in approximately half of children with small to moderate angle partially accommodative esotropia.
• Factors such as adequate preoperative prism wear for binocularity and sufficient surgical recession amount may enhance success rates.
• Further research is warranted to optimize surgical strategies for PAET.