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Bulgarian Review of Ophthalmology

Comparison between traditional bilateral and large unilateral medial rectus muscle recession for moderate esotropia

G. Dimitrova, B. Mihaylova


Introduction: In moderate esotropia there is a di1emma whether to operate on one muscle, performing a large unilateral recession (МRR) or on two muscles, performing traditional bilateral (ВМRR) recessions of medial rectus muscles.

Aim: То compare the effect Δ/mm recession of a large МRR and traditional BМRR in moderate esotropia as well as the motor outcome 6 months after surgery.

Material and methods: 200 patients with alternating/alternated esotropia were operated on for the period of 2000-2014. BМRR were performed in 170 patients (З40 eyes), the traditional (up to 5 mm) being in 16 (8%). Their effect Δ/mm recession was compared to the effect of large МRR which was performed in ЗО cases.
Diagnostic, surgical and statistical methods were used.

Results: No statistical difference was recorded between the two groups neither in the effect ?/mm recession, nor in the motor outcome 6 months after surgery.

Conclusion: Large MRR is a good alternative of traditional BMRR for achieving an optimal effect with a minimal surgical risk, especially in cases with preexisting anisometropia and amblyopia.


recession of medial rectus muscles; large recessions; surgical treatment of esotropia

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Tran HM, Mims JL, Wood RC: A new dose-response curve for bilateral medial rectus recessions for infantile esotropia. J AAPOS; 2002, 6:112-19.

Wang L, Wang X: Comparison between graded unilateral and bilateral medial rectus recession for esotropia. Br J Ophthalmol, 2012; 96:4.

Procianoy E, Justo MD: Results of unilateral medial rectus recession in high AC/A ratio esotropia. J Pediatr Ophthalmol Strabismus,1991; 28:212-4.

Stack RR, Burley CD, Bedggood A, Elder MJ: Unilateral versus bilateral medial rectus recession. J AAPOS, Aug 2003; 7(4):263-67.

Grin TR, Nelson LB: Large unilateral medial rectus recession for the treatment of esotropia. Br J Ophthalmol, 1987; 71:377-379.

Zak TA: Results of large single medial rectus recession. J Pediatr Ophthalmol Strabismus, 1986 Jan-Feb; 23(1): 17-21.

Bedrossian H: Management of small angle strabismus. Am Orthop J, 1968; 18:35-38

Israel MD, Deka A: Unilateral medial rectus recession for moderate angle esotropia. J AAPOS, Feb 2007; 11(1)-92.



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About The Authors

G. Dimitrova
Department of Ophthalmology, Medical University - Sofia, Alexandrovska University Hospital, Sofia

B. Mihaylova
Department of Ophthalmology, Medical University - Sofia, Alexandrovska University Hospital, Sofia