Comparison of the efficacy of medial rectus recession and lateral rectus resection for treatment of divergence insufficiency

Abstract

Purpose Surgical approaches for divergence insufficiency esotropia include medial rectus recession and lateral rectus resection. A retrospective chart review compared the efficacy of each. Methods Eighteen patients older than 50 years with divergence insufficiency esotropia who were operated on between 2005 and 2012 by two surgeons were reviewed. Results Nine patients underwent medial rectus recession and nine underwent lateral rectus resection. The average distance esotropia decreased from 19.75 to 3.2 prism diopters in the medial rectus recession group (P = .001) and from 17.7 to 2.6 prism diopters in the lateral rectus resection group (P = .0002). The disparity between distance and near alignment decreased from 7.3 to 3.4 in the medial rectus recession group (P = .019) and from 9 to 5.4 prism diopters in the lateral rectus resection group (P = .004). Conclusions Both medial rectus recession and lateral rectus resection are effective treatment for divergence insufficiency, with both decreasing distance-near disparity.