Results of classical and augmented bimedial rectus recession in infantile esotropia

• Published in: Strabismus Vol. 7; no. 4; pp. 227 - 236
• Main Authors: Altintas, Aysegül Koçak, Yilmaz, F. Gül, Duman, Sunay
• Format: Journal Article
• Language: English
• Published: England Informa UK Ltd 1999; Taylor & Francis
• Subjects: Adolescent; Child; Child, Preschool; Depth Perception; Esotropia - physiopathology; Esotropia - surgery; Eye Movements; Female; Humans; Infant; Male; Oculomotor Muscles - physiopathology; Oculomotor Muscles - surgery; Ophthalmologic Surgical Procedures - methods; Treatment Outcome
• ISSN: 0927-3972; 1744-5132
• DOI: 10.1076/stra.7.4.227.627

PURPOSE. To compare the success rates of augmented bimedial rectus recession and the standard recession. MATERIALS AND METHODS. Ninety patients were included in the study. The patients were evaluated in two groups according to the amount of recession. Group 1, the standard surgery group, received 5 mm or less of recession; Group 2, the augmented surgery group, received 6 mm of recession or more. The mean postoperative follow-up was 29 months (6-60 months) in Group 1, and 20 months (6-58 months) in Group 2. RESULTS. The mean age at the time of surgery was 4.61 years in Group 1 and 4.58 years in Group 2. The 56 patients in Group 1 underwent bilateral rectus recession varying from a minimum of 3 mm to a maximum of 5 mm; the 34 patients in Group 2 had recessions varying from a minimum of 6 mm to a maximum of 8 mm. The mean preoperative angle size was 39.64 ± 8.93 SD (range 20-50 PD) in the standard surgery group, and 59.70 ± 10.04 SD (range 51-85 PD) in the augmented surgery group. The average postoperative de viation was 13.37 ± 11.87 SD (range 0-45) in Group 1 and 9.02 ± 10.02 (range 0-45) in Group 2. A good surgical result was achieved with one operation in 29 of 56 patients (51.8%) in Group 1 and 24 of 34 patients (70.58%) in Group 2. DISCUSSION. The optimal surgical technique for the correction of large-angle esotropia is still controversial; it appears that the augmented bilateral medial rectus recession is an effective and reasonable alternative to three- or four-muscle procedures as the initial surgical treatment.