The authors evaluate the postoperative outcomes of unilateral medial rectus recession surgery for the treatment of persisting consecutive esotropia >10PD more than six months in 16 patients (three adults and 13 children) who were overcorrected after initial surgery for intermittent exotropia. This was a retrospective review. All patients were treated with part time occlusion of the dominant eye for several months before surgery for esotropia. Treatment was also with duction exercises and miotics (phospholine iodide 0.125%). Average esotropia was 19.43PD (10-28) at distance and 19.68PD (4-35) at near fixation. Surgery was undertaken at a mean of 8.56 months (6-16) after initial surgery for exotropia. Follow-up was for a mean of 29.25 months (6-72). Success was achieved in 10 cases. Six cases failed – five with recurrence of exotropia and one with undercorrection. The failed cases were patients with initial recession / resection surgery for exotropia. Unilateral medial rectus recession was undertaken to correct the esotropia and 15 cases regained bifoveal fixation. 

Surgical correction of consecutive exotropia with unilateral medial rectus recession surgery.
Adamopoulou C, Rao RC.
JOURNAL OF PEDIATRIC OPHTHALMOLOGY AND STRABISMUS

2015;52:343-7.
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Fiona Rowe (Prof)

Institute of Population Health, University of Liverpool, UK.

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