The Outcome of Bilateral Medial Rectus Muscle Recession in Esotropia

Purpose: To identify the postoperative surgical outcomes and the changes in deviation in patients treated by bilateral medial rectus (BMR) recession for small to large angle esotropia with a minimum follow-up of two years Methods: In this retrospective and consecutive case series, we reviewed medical records of 130 patients who had recession surgery for correction of esotropia between 2001-2011 in a tertiary center in Tehran. Patients were excluded if neurological abnormalities or developmental delays were documented and if structural eye abnormalities were present. Results: One month after operation (n=109), there were 85 successful cases (orthophoria or deviation less than 10 prism diopter), 18 cases of undercorrection, and six cases of overcorrection. The success rate at two years after surgery (n=82) was 78.2% with 13.3.% undercorrection and 8.5% over correction. The preoperative angle of esodeviation and patients’ age are found to significantly influence the response to the surgery. Conclusion: Surgery was effective because of high success rate and acceptable alignment after two years follow-up. Dose response increased in patients with larger angle of preoperative deviation, and was lower for patients who were older at the time of the surgery.