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.

Superior and lateral rectus myopexy for acquired adult distance esotropia: a one size fits all surgery.
Morad Y, Pres E, Nemet A.
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Fiona Rowe (Prof)

Institute of Population Health, University of Liverpool, UK.

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