Sameen Afzal Junejo, Arshad Ali Lodhi, Munawar Alam Ansari.
Surgical outcome of 7-millimeter bilateral medial rectus recession in large angle child esotropia.
Pak J Med Sci Jan ;26(3):589-94.

Objective: To evaluate the surgical success in the patients undergoing bilateral 7 mm medial rectus recession for large angle esodeviation. Methodology: The subjects less than 15 years of age presenting with concomitant esotropia with deviations of 60 prism diopter (PD) and more were registered for bilateral medial rectus recession surgery. Anterior segment slit lamp examination and posterior segment examination was performed with 90 D and 78D fundoscopes in selected cases. Angle of deviation was measured. All necessary investigations were completed. Surgical procedures were performed under general anesthesia. Postoperative follow-up was done. Results: Almost 71% children underwent successful surgery with residual deviation of less than 15 PD, while 29.0% subjects developed residual strabismus. Four patients presented with foreign body granuloma. Two children developed limitation in adduction. The preoperative deviations of 60 PD showed good results with residual deviation of fewer than 15 PD. Conclusion: There is a need for guarded muscle correction during bilateral medial rectus recession for improvement in visual alignment and binocular function.

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