Comparison of three  different surgical techniques for convergence excess esotroia

Abstract

The surgical management of convergence excess esotropia (CEET) with near-far disparity (NFD) is a challenging problem. We aim to compare the results of three different surgical procedures; bilateral medial rectus recession(MRR), combined recession–resection (CRR) and Y - splitting recession(YSR) of the medial rectus (MR) muscle. This was a retrospective comparative study of 60 patients records from (2019–2023) who met the inclusion criteria with CEET (NFD), had on their whole cycloplegic refraction and underwent surgical treatment. An acceptable result was outlined as orthophoria or esotropia, less than 10 prism diopters (Δ) at far and near with decline of the NFD to less than 10 Δ at the ending of the follow up period of 2 years. 13 of 20 patients (65%), 15 of 20 patients (75%), 18 of 20 patients (90%), had acceptable results at far and near in Group I (MRR), Group II (CRR) and Group III (YSR) respectively (p value was 0.21) statistically insignificant. No cases of overcorrection (exotropia) were reported at the final follow up visit (2 years) in the three groups. The three surgical techniques were successful but CRR was the most successful, durable, with steadiness of outcomes but extended follow-up periods are even so necessary.