title: Bilateral medial rectus recession in convergence excess esotropia, with and without distance orthophoria.
abstract: OBJECTIVE
  To evaluate the effectivity and safety of bilateral medial rectus recession for the correction of acquired convergence excess esotropia, with and without distance orthophoria.
  
  
  METHODS
  Thirty-five pediatric patients with acquired convergence excess esotropia were operated with bilateral medial rectus recessions based on the near angle measured through the distance correction. Preoperatively, in 26 patients, full hypermetropic correction did not fully correct the distance angle; these patients were operated for the residual angle for distance and near. In nine patients full hypermetropic correction produced distance orthophoria and these cases also had near orthophoria through a near add; these patients could have used bifocals, but surgery was chosen instead.
  
  
  RESULTS
  Postoperatively, 19 of the 26 patients with distance esotropia (73%) and 6 of the 9 with distance orthophoria (66.6%) were successfully aligned. Consecutive exotropia developed in two patients (7.6%) in the distance esotropia group and one (11.1%) in the distance orthophoria group.
  
  
  CONCLUSIONS
  These results suggest that bilateral recession of the medial recti based on the near deviation is effective in eliminating the near angle in convergence excess esotropia. In patients with distance orthophoria this operation can be used as an initial treatment instead of bifocals. Although the risk of consecutive exotropia was low in this series, a larger number of patients would determine its actual rate more accurately.
authors.affiliation: Athens University Eye Clinic, Greece.
authors.forename: A G
authors.initials: AG
authors.lastname: Damanakis
authors.forename: P G
authors.initials: PG
authors.lastname: Arvanitis
authors.forename: A
authors.initials: A
authors.lastname: Kalitsis
authors.forename: I D
authors.initials: ID
authors.lastname: Ladas
mesh_terms: D002648:Child; D002675:Child, Preschool; D004948:Esotropia / Q000601:surgery*; D005069:Evaluation Studies as Topic; D005099:Exotropia / Q000209:etiology; D006801:Humans; D006956:Hyperopia / Q000601:surgery