Clinical Research on the Efficacy of Modified Surgery for Esotropia Fixus With High Myopia.

Abstract

To investigate the efficacy of a modified surgical procedure for esotropia fixus with high myopia. Thirteen patients (15 eyes) with esotropia fixus and high myopia who underwent the Jensen procedure for superior and lateral rectus muscles at Southwest Hospital between February 2014 and December 2015 were retrospectively analyzed. Intraoperatively, the superior rectus and lateral rectus muscles were separated up to 12 to 14 mm posterior to their respective insertion. A medial rectus large recession or rectus tenotomy was performed based on the degree of fibrosis of the medial rectus muscle. Postoperative examinations were performed at 1 day, 2 weeks, 3 months, and 6 months. On the first postoperative day, 12 eyes (10 patients) were in the primary position (80.0%), 2 eyes (2 patients) exhibited 5° to 10° esotropia (13.3%), and 1 eye (1 patient) exhibited 15° esotropia (6.7%). At the 2-week follow up, 1 eye (1 patient) was lost to follow-up, 9 eyes (7 patients) were in the primary position (64.3%), 3 eyes (3 patients) exhibited 10° esotropia (21.4%), and 2 eyes (2 patients) exhibited 15° to 20° esotropia (14.3%). At the 3-month follow-up, the patient whose ocular alignment was 20° esotropia at 2 weeks was found to have developed 30° esotropia; no change was observed in the other patients. A remarkable improvement in ocular motility was observed in all patients. The Jensen procedure for the union of the superior rectus and lateral rectus muscles, using two pairs of sutures applied 12 to 14 mm posterior to their respective insertions, yielded favorable outcomes. [J Pediatr Ophthalmol Strabismus. 2018;55(4):219-224.].