Retrospective review of ocular alignment after large-angle congenital esotropia surgery

Abstract

Objective: The study’s aims were to evaluate the success of bimedial rectus recession as a primary surgical procedure for patients with congenital esotropia; describe the demographic data of the study group; and compare surgical success with patient age at the time of surgery. Method: A retrospective review of 52 patients with congenital esotropia ≥ 50∆ (prism dioptres) was conducted. All patients underwent bimedial rectus recession and were followed-up postoperatively for a minimum of 6 months. Results: The study period was from January 1992 to September 2003. Fifty-two patients were included in the study group. The pre-operative angle of deviation ranged from 50∆–85∆. Patient ages ranged from 15 months to 22 years, with a mean of 5.3 years and a median of 4 years. The gender distribution was 42% male (n = 20) and 58% female (n = 28). Surgery was successful (within 10∆ of orthophoria) in 77% (n = 40), a partial success (10∆–20∆ from orthophoria) in 17% (n = 9) and a failure (> 20∆ from orthophoria) in 6% (n = 3). No statistically significant relationship was found between surgical success and patient age at the time of surgery. Conclusion: The study confirmed that bilateral medial rectus recession, performed as a primary procedure for patients with large-angle (> 50∆) congenital esotropia, has a high success rate. This finding corresponds with the outcomes of similar international studies.

Keywords

• congenital esotropia, large angle esotropia, bimedial rectus recession, South Africa