A randomised comparison of bilateral recession versus unilateral recession-resection as surgery for infantile esotropia.
OBJECTIVE
Infantile esotropia, a common form of strabismus, is treated either by bilateral recession (BR) or by unilateral recession-resection (RR). Differences in degree of alignment achieved by these two procedures have not previously been examined in a randomised controlled trial.


METHODS
Controlled, randomised multicentre trial.


METHODS
12 university clinics.


METHODS
124 patients were randomly assigned to either BR or RR. Standardised protocol prescribed that the total relocation of the muscles, in millimetres, was calculated by dividing the preoperative latent angle of strabismus at distance, in degrees, by 1.6.


METHODS
Alignment assessed as the variation of the postoperative angle of strabismus during alternating cover.


RESULTS
The mean preoperative latent angle of strabismus at distance fixation was +17.2 degrees (SD 4.4) for BR and +17.5 degrees (4.0) for RR. The mean postoperative angle of strabismus at distance was +2.3 degrees (5.1) for BR and +2.9 degrees (3.5) for RR (p = 0.46 for reduction in the angle and p = 0.22 for the within-group variation). The mean reduction in the angle of strabismus was 1.41 degrees (0.45) per millimetre of muscle relocation for RR and 1.47 (0.50) for BR (p = 0.50 for reduction in the angle). Alignment was associated with postoperative binocular vision (p = 0.001) in both groups.


CONCLUSIONS
No statistically significant difference was found between BR and RR as surgery for infantile esotropia.
Polling
J-R
JR
Department of Ophthalmology, Erasmus MC Rotterdam, Rotterdam, The Netherlands.
Eijkemans
M J C
MJ
Esser
J
J
Gilles
U
U
Kolling
G H
GH
Schulz
E
E
Lorenz
B
B
Roggenkämper
P
P
Herzau
V
V
Zubcov
A
A
ten Tusscher
M P M
MP
Wittebol-Post
D
D
Gusek-Schneider
G C
GC
Cruysberg
J R M
JR
Simonsz
H J
HJ