The surgical treatment of consecutive esotropia following bilateral lateral rectus recession

Abstract

Objective To analyze the cause and surgical treatment of consecutive esotropia following bilateral lateral rectus recession.Methods Seventeen patients were operated on for consecutive esotropia which persisted over 6 months after exotropia surgery were analyzed retrospectively from June 2009 to July 2013.All patients had undergone first surgery with recession of both lateral rectus muscles,the lateral rectus muscles were recessed from 5 mm to 10 mm,and there were 11 patients' recession was more than 8mm.Different operation was performed which depended on eye movement,deviation and force duction.All patients were followed up for 1 year.Results Two patients were treated with recession of medial rectus; 10 patients with abduction impairment were treated with advancement at insertion of lateral rectus muscle on one eye,while 2 patients were on both eye; the other patients with large angle esotropia in primary position were treated with advancement of lateral rectus combined with recession of medial rectus.Postoperatively,17 patients were orthophoria without diplopia or abnormal head position,mean deviation was (-1.8±5.0)△,(-3.2±5.0)△ as long term follow up.The success rate was 88.24％ (15/17).All patients were satisfied with the surgical correction and no one needed more surgery.Conclusions The large recession of bilateral lateral rectus muscle maybe cause esotropia.Different surgical management which depends on eye movement,deviation and force duction is effective for consecutive esotropia. Key words: Consecutive esotropia; Strabismus surgery