The purpose of this study was to evaluate the outcome of this surgical approach in the treatment of divergence insufficiency esotropia. This was a retrospective review of 18 patients aged on average 49.6 years; 77% were female. Preoperatively the distance angle was 24.3PD eso and, for near 15.7PD. Duration of esotropia was six months or more. All patients were myopic (mean -5.54D) and 16% complained of diplopia. Twelve had prisms prior to surgery. Surgery involved bilateral superior rectus / lateral rectus myopexy. Seven also had medial rectus recession of 2-6mm for larger deviations and two had a single inferior rectus recession for a larger vertical associated deviation. Follow-up was of 3-52 months (average 17 months) and 16 patients achieved a deviation <4PD. For two patients the deviation recurred after 6-12 months requiring a further medial rectus recession but obtaining good results. Diplopia resolved for all patients. The authors propose this as an effective treatment option.