Augmented Medial Rectus Recession with Non-Absorbable Suture Loops is Effective in the Treatment of Convergence Excess Esotropia

ABSTRACT

Aim:To evaluate the surgical outcomes of augmented medial rectus recession with non-absorbable 5.0 white braided polyester suture (Alcon Laboratories, Forth Worth, Texas, USA) loops in patients diagnosed with convergence excess esotropia. Methods: Clinical records of 21 patients with convergence excess esotropia who have been operated with symmetric medial rectus recessions augmented with non-absorbable suture loops were reviewed. Initial scleral bite was planned according to the distance deviation. Non-absorbable sutures tied leaving a loose loop which was 1 mm for a near–distance disparity of 10 PD, 1.5 mm for 15PD, and 2 mm for 20 PD. Postoperative changes in near-distance disparity were evaluated. Results: The mean preoperative near-distance disparity of 17,21 ± 1,68 standard mean of error (SE) prism diopters (PD) decreased to 3,15 ± 0,88 PD SE at 12 month postoperatively. Near-distance disparity of 10 PD or less was achieved in all patients after surgery at the sixth month, 1 patient showed 12 PD of disparity at the first-year control. No overcorrection has been noted. Conclusion: Bilateral medial rectus muscle recession procedure augmented with polyester suture loops effectively decreases the disparity between near and distance deviations in patients with convergence excess esotropia. Because of our good results and an easy, noninvasive approach without any additional complications, we recommend this technique to treat convergence excess esotropia

KEYWORDS:

• Esotropia
• Convergence excess
• Augmented recession

ACKNOWLEDGMENTS

We would like to add special thanks to Mr. Emrullah Yavuz for the illustration (Figure 1) he drew.