The Surgical Treatment of Convergence Insufficiency Type Exodeviation

Abstract

Objective:

The purpose of this study is to determine the outcome of patients surgically treated for symptomatic convergence insufficiency type exodeviation.

Design:

A retrospective chart review was performed on patients undergoing medial rectus resection for symptomatic convergence insufficiency type exodeviation.

Participants:

Eighteen patients were studied.

Intervention:

All patients underwent a medial rectus resection surgical procedure.

Main outcome measures:

Objective strabismus deviations at distance and near, fusion and stereopsis were measured. Subjective symptoms and the need for postoperative prism were examined.

Results:

Thirteen of eighteen patients needed prism at sometime in the postoperative period; ten needed prism at the last postoperative visit. The medial rectus resection procedure was powerful, correcting 25^Δ to 73^Δ of near exodeviation measured at the first postoperative visit. Postoperative drift averaged 18.4^Δ at near and 23.3^Δ at distance, with most drift occurring in the first six weeks.

Conclusions:

The medial rectus resection procedure is effective for correcting even large angles of convergence insufficiency exodeviation. The risk of postoperative overcorrection, need for prism, and recurrence is noteworthy.

• convergence insufficiency
• surgery
• exodeviation