Surgical Correction of Consecutive Esotropia With Unilateral Medial Rectus Recession

Purpose: Unilateral medial rectus recession is a treatment option to surgically correct consecutive esotropia. This study evaluated the surgical outcomes of patients who underwent unilateral medial rectus recession for the treatment of consecutive esotropia after surgery for intermittent exotropia. Methods: The medical records of 16 patients who underwent surgical correction of consecutive esotropia with unilateral medial rectus recession were retrospectively reviewed. Patients with intermittent exotropia who were previously treated with one or multiple surgical procedures (8 bilateral lateral rectus recession, 7 recess-resect procedure, or 1 bilateral medial rectus resection) were included in the study. Three patients were adults and 13 patients were children. The mean age was 5 years for children and 50.3 years for adults. Consecutive esotropia was defined as residual manifest esodeviation of 10 prism diopters (PD) at 6 months postoperatively. Successful correction of consecutive esotropia was defined as the lack of manifest or intermittent tropia and esophoria/exophoria within 8 PD. Patients with monofixational exotropia were excluded from the study. Results: Unilateral medial rectus recession was successful in the correction of consecutive esotropia in 10 of 16 cases (62.5%). Six of 16 (37.5%) patients had unsatisfactory postoperative alignment, with 5 patients showing recurrence of exotropia. Only one patient was undercorrected. Conclusions: The success rate of surgical correction of consecutive esotropia with single muscle surgery was good. Recurrence of exotropia accounted for most of the failures, and all recurrences occurred in the group of patients initially treated surgically for intermittent exotropia with a recess-resect procedure.