Medial rectus fadenoperation for esotropia only at near fixation

Millicent, M.; Peterseim, W.; Buckley, Edward G.

doi:10.1016/s1091-8531(97)90051-3

Cited by 36 publications

(15 citation statements)

References 19 publications

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“…Group B included 10 patients treated with symmetric medial rectus recession combined with posterior fixation sutures placed 12-14 mm from insertion. Group C included 10 patients treated with symmetric slan- (12), in retrospective study of esotropia for near with high AC/A ratio that underwent bilateral Faden (no recession), found that 95% of patients had normalized their AC/A ratio, 70% attained 400 seconds of arc stereoacuity (versus 44% preoperatively), and 86% were able to maintain satisfactory near ocular alignment without the need for postoperative bifocals. Clark et al (13,14) reported that medial rectus posterior fixation suture reduces medial rectus force during convergence and augments medial rectus recession, decreasing excess near esotropia.…”

Section: Methodsmentioning

confidence: 99%

Augmented Medial Rectus Recession, Medial Rectus Recession plus Faden, and Slanted Medial Rectus Recession for Convergence Excess Esotropia

Khalifa

2010

European Journal of Ophthalmology

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Section: Methodsmentioning

confidence: 99%

Augmented Medial Rectus Recession, Medial Rectus Recession plus Faden, and Slanted Medial Rectus Recession for Convergence Excess Esotropia

Khalifa

2010

European Journal of Ophthalmology

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“…Bilateral MR scleral PF has been used for treatment of ET manifest only at near, resulting in good motor alignment, decreased necessity for bifocal wear, and improved binocular function (Millicent et al, 1997). Complications have been problematic, however.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Outcome of Medial Rectus Recession and Pulley Posterior Fixation in Esotropia With High AC/A Ratio

Wabulembo¹,

Demer²

2012

Strabismus

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Purpose: Medial rectus (MR) recession with pulley posterior fixation (PF) can be used to treatesotropia (ET) with a high accommodative convergence to accommodation (AC/A) ratio as effectively in the short term as MR recession with scleral PF. This study provides a novel examination of the long-term results of MR recession with pulley PF (PPF). Methods: In 21 children we performed bilateral MR recession and pulley PF for ET greater at near than distance (high AC/A). Mean follow-up was 3.5 ± 2.5 (standard deviation [SD]) years. Results: Mean age at presentation was 2.7 ± 1.8 and at surgery 4.3 ± 1.6 years. Fourteen (67%) children had amblyopia. Distance and near pre-operative ET averaged 19.6Δ ± 10.5Δ and 36.9Δ ± 18.9Δ, respectively. Mean near-distance (N-D) disparity was 16.4Δ ± 12.3Δ. The MR recession averaged 4.4 ± 0.9 mm. Early mean postoperative ET was 1.3 ± 3.3Δ at distance and 2.8Δ ± 5.2Δ at near. Mean late postoperative ET was 0.1Δ ± 5.8Δ and 1.0Δ ± 6.2Δ at distance and near, respectively. At the final postoperative examination, mean N-D disparity was reduced to 0.9Δ ± 3.6Δ. Discussion: MR recession with PPF has a high long-term effectiveness, even in patients with amblyopia and autism. Since no posterior scleral suturing is required, it minimizes the perforation risk associated with scleral PF. Conclusion: MR recession with PPF is a safe and highly effective long-term treatment for ET with high AC/A ratio. Long-term results may surpass those of alternate procedures.

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“…Surgical correction can reduce the AC/A ratio 121,122 and eliminate the need for bifocal wear without producing consecutive exotropia at distance. [123][124][125] Prism Therapy…”

Section: Bifocalsmentioning

confidence: 99%