Bimedial recti slanted recession versus bimedial recti Y-split recession for surgical management of infantile-onset esotropia

Abstract

Context Bimedial recti Y-split recession is a new intervention for the weakening of the medial recti muscle in patients suffering infantile-onset esotropia. Few studies assessed the efficacy and safety of this procedure compared with other procedures that have been in use. Aims To evaluate bimedial recti slanted recession versus bimedial recti Y-split recession for surgical management of infantile-onset esotropia. Patients and methods This cohort study included patients with infantile esotropia. Patients were divided into two groups according to the procedure performed (bimedial recti Y-split recession or slanted recession). Patients were followed up on the first postoperative day, the first week, first month, 3 months, 6 months, and 1 year. In each visit, deviation and full ocular motility assessments were performed. Results The Y-split recession group showed a higher success rate than the slanted recession group (93.4 vs. 53.4%). Consecutive exotropia was detected in 6.7% of the slanted recession group, but was not observed in the Y-split recession group. Conclusions Bimedial recti Y-split recession was superior to bimedial recti slanted recession as manifested by the higher success rate of the former and the stability of its results all over follow-up visits until 1 year postsurgery.

Keywords

• convergence excess
• infantile esotropia
• medial rectus muscle
• slanted recession
• y-split recession