Augmented medial rectus recession, medial rectus recession plus Faden, and slanted medial rectus recession for convergence excess esotropia

PURPOSE. To evaluate the efficacy of 3 different surgical techniques for convergence excess esotropia: augmented medial rectus recession, medial rectus recession plus Faden, and slanted medial rectus recession. METHODS. Twenty-nine patients with convergence excess esotropia were divided into 3 groups. Group A included 9 patients treated with medial rectus muscle recession augmented with 1-2 mm more of the standard recession. Group B included 10 patients treated with standard recession plus Faden. Group C included 10 patients treated with slanted medial rectus recession. Surgical success was defined as esotropia (ET) 10 prism diopters (Delta) or less at distance and near with collapse of distance/near disparity. RESULTS. Satisfactory alignment with elimination of bifocal correction was noted in group A (66.6%). In groups B and C, the results were 70%. Group A patients had a mean reduction in distance/near disparity from 15.5 +/- 1.5 Delta preoperatively to 4.7 +/- 2.5 Delta postoperatively, while in group B the preoperative distance/near disparity was 16.5 +/- 1.8 Delta and decreased to 3.8 +/- 3.1 Delta postoperatively, and group C also showed reduction in distance/near disparity from 18.1 +/- 1.6 Delta preoperatively to 4.5 +/- 3.6 Delta postoperatively. There were no statistically significant differences among the 3 groups. CONCLUSIONS. The 3 procedures are effective surgical options to treat convergence excess esotropia with acceptable motor outcomes.