The Effect of Lateral Rectus Muscle Advancement in Consecutive Esotropia After Bilateral Rectus Muscle Recession

Abstract

Purpose: To investigate the clinical outcomes of unilateral lateral rectus muscle advancement in patients with consecutive esotropia after bilateral lateral rectus muscle recession. Methods: We investigated the results of 13 patients who underwent unilateral lateral rectus muscle advancement for consecutive esotropia after bilateral lateral rectus muscle recession. We evaluated the amount of deviation, changes of angle deviation, corrected amount/mm, and sensory status after each surgery. Results: The average angle deviation of exotropia was 30.42±5.41PD, and the average amount of bilateral lateral rectus muscle recession was 6.73±0.59 mm. The average angle deviation of esotropia one day after the surgery was 13.17±5.15PD. Occlusion treatment was performed during follow-up. The surgery for consecutive esotropia was performed after an average of 12.0±7.25 months of follow-up. In Worth-4-dot tests, 12 patients showed diplopia, and 1 patient showed suppression after the surgery for exotropia. Nine patients showed diplopia, and 4 patients showed suppression just before the surgery for consecutive esotropia. One patient showed mild limitation of motion of the lateral rectus muscle (-1 degree). The average angle deviation before the surgery for consecutive esotropia was 19.42±4.20PD. An average of 6.73±0.79 mm of unilateral lateral rectus muscle advancement was performed. After surgery, the average angle deviation was 1.25±2.73PD esodeviation, and 1.42±4.44PD exodeviation after 6 months. In Worth-4-dot tests, 6 patients showed fusion, 2 patients showed diplopia, and 5 patients showed suppression after surgery for consecutive esotropia. Conclusions: Unilateral lateral rectus muscle advancement was an effective procedure for patients with consecutive esotropia under 25PD who did not show any limitation of motion after bilateral lateral rectus recession.