Medial rectus recession combined with bridge faden procedure in esotropia associated with poor vision in the deviating eye

Purpose

To evaluate the postoperative outcomes of medial rectus recession combined with modified posterior fixation surgery (bridge faden) in esotropia associated with poor vision in the deviating eye.

Methods

In this retrospective study, the surgical outcomes of patients who underwent medial rectus recession combined with the bridge faden procedure for esotropia with poor vision in the deviating eye from April 2016 to May 2023 were assessed. The demographic characteristics of the patients and near and distance deviations were determined using the prism cover or the Krimsky test preoperatively and at follow-up of 1 month, 6 months, and 1 year. Orthophoria or ±10^Δ deviation in postoperative near and distance deviations were considered surgical successes. The Wilcoxon signed-rank test was used for statistical analysis. A P value of <0.05 was considered statistically significant.

Results

A total of 57 patients (34 males) were included. Mean patient age was 19 ± 12 years; mean follow-up, 27 ± 33 months. Near deviations improved from a mean of 33 ± 8^Δ preoperatively to 4 ± 7^Δ at 1 year (P < 0.05), and distance deviations improved from a mean of 27 ± 10^Δ preoperatively to 3 ± 7^Δ at 1 year (P < 0.05). The surgical success rate at final follow-up was 86%.

Conclusions

In our cohort of patients with sensory esotropia associated with poor vision in the deviating eye, our procedure provided long-term improvement in near and distance deviation.