Surgical Effect of Medial Rectus Posterior pulley fixation in Esotropia greater at near fixation

Abstract

PurposeTo determine the surgical effect of medial rectus posterior pulley fixation in esotropia greater at near fixation.MethodsMedical records of consecutive patients who underwent medial rectus posterior pulley fixation for esotropia greater at near fixation and followed up at least 1 year were reviewed retrospectively. Surgical success was defined as orthotropic or ≤8 prism diopters (PD) esotropia at distance at 1 year after surgery. Preoperative and postoperative deviation, distance‐near disparity and the sensory status were evaluated. Stereoacuity was measured with Titmus test and normal stereoacuity was defined as ≤100 arc sec at one year after surgery.ResultsSixteen patients were included the study. The mean age at surgery was 6.29 ± 2.17 years (range 3.00–9.92) and mean follow up period was 18.8 ± 4.79 months (range 12.00–27.00). Preoperative angle of deviation was 23.31 ± 12.37 PD at distance, 33.81 ± 10.95 PD at near and distance‐near disparity was 10.50 ± 4.77 PD. Twelve patients underwent bilateral medial rectus recession and 4 underwent unilateral medial rectus recession. Fourteen (85.8%) patients achieved surgical success and 2(14.2%) patients were undercorrected. The mean distance‐near discrepancy was 5.81 ± 4.48 PD at 1 year after surgery, which was significantly decreased (p = 0.018, Wilcoxon signed ranked test). Normal stereoacuity at near fixation was achieved in 10 (32.5%) patients at 1 year after surgery.ConclusionsMedial rectus posterior pulley fixation may be the effective method in esotropia greater at near fixation.