Twenty-five patients with high accommodative convergence/accommodation (AC/A) ratios and near esotropia of 15 to 35 prism diopters were treated with a 6- to 8-mm unilateral medial rectus recession according to the near deviation. In 24 patients (96%), the esodeviation was aligned within 10Δ, with a follow up ranging from 3 to 7 years. Only one patient had greater than 10Δ of esotropia (14Δ), and none became exotropic. This procedure appears to be a safe and effective method in the treatment of esotropia with high AC/A ratios, in a selected group of patients.

A patient with Terrien's corneal marginal degeneration and a previous trabeculectomy had planned extracapsular cataract extraction with intraocular lens implantation. A corneal incision was made with a diamond blade on the degeneration furrow superiorly and was closed with a 10-0 nylon double-running suture with keratoscopic control.