Augmented medial rectus recession, medial rectus recession plus Faden, and slanted medial rectus recession for convergence excess esotropia.

PURPOSE: To evaluate the efficacy of 3 different surgical techniques for convergence excess esotropia: augmented medial rectus recession, medial rectus recession plus Faden, and slanted medial rectus recession.

METHODS: Twenty-nine patients with convergence excess esotropia were divided into 3 groups. Group A included 9 patients treated with medial rectus muscle recession augmented with 1-2 mm more of the standard recession. Group B included 10 patients treated with standard recession plus Faden. Group C included 10 patients treated with slanted medial rectus recession. Surgical success was defined as esotropia (ET) 10 prism diopters (Δ) or less at distance and near with collapse of distance/near disparity.

RESULTS: Satisfactory alignment with elimination of bifocal correction was noted in group A (66.6%). In groups B and C, the results were 70%. Group A patients had a mean reduction in distance/near disparity from 15.5±1.5Δ prism diopters preoperatively to 4.7±2.5Δ prism diopters postoperatively, while in group B the preoperative distance/near disparity was 16.5±1.8Δ prism diopters and decreased to 3.8±3.1Δ prism diopters postoperatively, and group C also showed reduction in distance/near disparity from 18.1±1.6Δ prism diopters preoperatively to 4.5±3.6Δ prism diopters postoperatively. There were no statistically significant differences among the 3 groups.

CONCLUSIONS: The 3 procedures are effective surgical options to treat convergence excess esotropia with acceptable motor outcomes.