Three horizontal muscle surgery for large-angle esotropia: Success rate and dose-effect ratio

Abstract

• AIM: To evaluate the moderate-term success and calculate the mean dose-effect ratio in large-angle esotropic patients who underwent three muscle surgery. • METHODS: In a retrospective study, we reviewed the medical records of 37 patients with large-angle esotropia who underwent bilateral medial rectus recession and one lateral rectus resection. Sex, age at surgery time, amount of recessed or resected muscles in millimeter (mm), preand postoperative alignment in prism diopter (D), dose/response ratio, and presence of amblyopia and other associated vertical deviations were recorded. • RESULTS: The mean age of subjects at surgery was 12.2±12.3y (range: 1-57). The mean preoperative deviation of 70.4±8.1 D (range: 60-85 D) decreased to a mean of 5.4±8.1 D (range: 0-30 D) postoperatively (P<0.005). Successful alignment was achieved in 30 of 37 patients (81%) at a mean follow-up of 15.7±20.1mo (range: 3-90). The mean amount of recession and resection was 17.59±1.29 mm, and a mean dose-response ratio of 3.79±81 (range: 2.83-4.66) was determined. • CONCLUSION: Three-muscle surgery for large-angle esotropia results in good moderate-term outcomes without high rates of overcorrection or undercorrection.