Lateral rectus resection versus medial rectus re-recession for residual esotropia: early results of a randomized clinical trial.
OBJECTIVE
To compare lateral rectus muscle resection with medial rectus muscle re-recession for patients with residual esotropia.


METHODS
This randomized controlled clinical trial included 25 patients (mean age, 18.8 +/- 8.7 years) with residual esotropia who were candidates for reoperation. They were randomly assigned into two groups: re-recession group (n = 12), in which the medial rectus muscle was recessed again, and the resection group (n = 13), in which lateral rectus muscle resection was performed. Postoperative deviation < or =10 prism dioptres was considered to be treatment success.


RESULTS
The success rate of the re-recession group and the resection group was 67% and 54%, respectively; this difference was not statistically significant. Each 1 mm of medial rectus re-recession and lateral rectus resection corrected 7.5 +/- 1.2 and 2.5 +/- 0.5 prism dioptres of residual esotropia, respectively. In 50% of the re-recession group, mild medial rectus muscle underaction occurred; however, only 16.5% developed an increase in the near point of convergence. Major intraoperative and postoperative complications, including overcorrection and slippage or a lost muscle, did not occur in any of the patients.


CONCLUSIONS
Medial rectus muscle re-recession can be a substitute for lateral rectus muscle resection in patients with residual esotropia. The resultant underaction of the medial rectus muscle after re-recession is relatively mild and causes no major problems.
Rajavi
Zhale
Z
Imam Hossein Medical Centre, Shaheed Beheshti Medical University, Tehran, Iran. zh_ra2000@yahoo.com
Ghadim
Hashem M
HM
Ramezani
Alireza
A
Azemati
Mansoor
M
Daneshvar
Faride
F
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004948:Esotropia / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D009801:Oculomotor Muscles / Q000503:physiopathology / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D016896:Treatment Outcome; D015348:Vision, Binocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology