Long-term results of bimedial rectus recessions in infantile esotropia.

BACKGROUND: Congenital esotropia has a deviation of 50 or more prism diopters (delta). Generally, surgical alignment of the eyes is the accepted treatment but surgical techniques differ. METHODS: A total of 54 patients were evaluated. Surgery was done at a mean age of 28 months. Bimedial rectus recessions up to 8 mm were performed. RESULTS: The mean preoperative deviation was 70 delta of esotropia. Our success rate with a uniform approach was 66.6%. CONCLUSIONS: Contrary to the selective approach for large angle congenital esotropia, we do not consider initial surgery on three or more muscles. Our method is quicker, simpler, less traumatic, and leaves the lateral rectus muscles unoperated for patients requiring a second surgery.