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Unilateral Medial Rectus Recession for Correction of 20 to 30 ∆ of Esotropia
1Ophthalmology Department, Cairo University, Cairo.
Insights
Unilateral medial rectus recession effectively treats pediatric esotropia (20-30∆). This surgery shows high success rates with minimal undercorrection or duction limitations, making it a viable option for strabismus correction.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Strabismus Surgery
Background:
- Esotropia is a common form of strabismus in children.
- Surgical correction is often necessary for moderate to large angle esotropia.
- Medial rectus recession is a standard surgical technique for esotropia.
Purpose of the Study:
- To evaluate the efficacy of unilateral medial rectus recession in correcting moderate esotropia (20-30 prism diopters) in pediatric patients.
- To assess the outcomes and potential complications of this surgical approach.
Main Methods:
- A prospective study included 21 pediatric patients aged 1-12 years with esotropia.
- Surgical target angles were calculated based on specific criteria.
- Outcomes were assessed at a minimum of 3 months postoperatively, defining success as orthotropia or ≤10∆ horizontal tropia.
Main Results:
- A successful motor outcome was achieved in 85.7% of patients.
- The failure rate (14.3%) was primarily due to undercorrections.
- Persistent lateral incomitance and mild duction limitations were observed in a small percentage of cases, with no correlation to surgical parameters.
Conclusions:
- Unilateral medial rectus recession is a reasonable surgical option for pediatric esotropia (20-30∆).
- The procedure demonstrates a low rate of overcorrection and acceptable rates of undercorrection and mild duction limitation.
- This approach offers a favorable risk-benefit profile for correcting moderate esotropia.
Purpose:
To evaluate the effect of unilateral medial rectus (MR) recession for the correction of 20 to 30 ∆ of esotropia.
Methods:
Pediatric patients with esotropia (ET) with a surgical target of 20 to 30 prism diopters (∆) were included in a prospective study to determine the effect of unilateral MR recession. The surgical target angle was calculated as the average of the distant angle with glasses and near without glasses, or the average of distant and near angles without glasses (if non-significant refractive error), or the average of near angles with and without glasses (if ET was measured using the modified Krimsky test). The study endpoint was the last follow-up visit, conducted at least 3 months postoperatively. A successful motor outcome was defined as orthotropia or a horizontal tropia of 10∆ or less at distance and near.
Results:
The study included 21 patients, 1 to 12 years of age. Patients were followed up for 3 to 43 (mean+/-SD 12.5+/-10.6) months. A successful outcome was achieved in 85.7%, with no correlation to the surgical target angle or the amount of recession (p > .05). The 14.3% failure rate was attributed to undercorrections. Persistent lateral incomitance was observed in 10.5% of cases and was not correlated with the surgical target angle or the amount of recession (p > .05). Persistent limited ductions were mild (-1).
Conclusions:
This prospective study of pediatric patients showed that unilateral MR recession is a reasonable surgical approach for treating esotropia of 20-30 ∆, with small rates of undercorrection and duction limitation, and no overcorrection.
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