Retroequatorial myopexy combined with bimedial recession for near-distance disparity esotropia

Abstract

Retroequatorial myopexy (fadenoperation) alone and combined with bimedial recession is an effective procedure in treating esotropia with abnormal near-distance disparity.

Combined resection–recession versus combined recession–retroequatorial myopexy of medial rectus muscles for treatment of near-distance disparity Esotropia

“…Our results showed no incidence of exotropia at far but the success rate was 71.4%, with 4 cases with near-distance disparity >10 PD, which agreed with previous studies9 and was less than other studies7 in which success rate was 88%. This difference may be attributed to the very short follow-up period of the other study (3 months only) compared with our 2-year follow-up period.…”

“…The surgical management of near-distance disparity esotropia represents a challenging problem. Augmented medial rectus recession,6 medial rectus recession combined with retroequatorial myopexy7 and slanted rectus recession8 were modalities for surgical treatment 9…”

Medial rectus Faden operations with or without recession for partially accommodative esotropia associated with a high accommodative convergence to accommodation ratio

“…Our inclusion criteria for surgery were consistent with criteria used in previous studies. In the literature, some authors have reported that 70–88% of patients were able to maintain satisfactory ocular alignment (<10 pd) and 81–93% of these patients showed reduced near–distance disparity (<10 pd) at an average of 5 months and 3 years follow-up after Faden operations on the MR muscles combined with recession for partially accommodative esotropia with a high AC : A ratio 8 10 13 14 24. In our series, the mean follow-up period was 4.8 years and 171 (47%) patients had a mean postoperative follow-up of 6 years.…”

“…We believe that the posterior fixation suture combined with MR muscle recession is an effective treatment for partially accommodative esotropia associated with a high AC : A ratio and that it results in an infrequent prevalence of overcorrection and undercorrection. In multiple studies,6 8 10 the incidence of secondary exotropia occurring after Faden operations on the MR muscles with recession has been reported as 0–14.3%, whereas the incidence of residual esotropia after these operations has been reported as 12–30%.…”

Do bifocals reduce accommodative amplitude in convergence excess esotropia?

“…Several ophthalmologists also prescribe exercises to promote dissociation between accommodation and convergence [8,9]. If near esotropia persists, after several years of using bifocal lenses, a double recession of the medial rectus muscles can solve the problem, eliminating near deviation without generating strabismus for far [10][11][12][13]. Some studies, however, published by Breinin et al [14] and subsequently von Noorden and Jenkins [15,16], indicate that even therapy with bifocal lenses is not risk-free.…”