This article is more than 5 years old. Information may no longer be current.
Medial rectus recession effective treatment for adult-onset esotropia
Click Here to Manage Email Alerts
WAIKOLOA, Hawaii – Bilateral medial rectus recession was found to be an effective treatment for adults with chronic, slowly progressive esotropia, said one surgeon speaking here.
Erick D. Bothun, MD, and researchers conducted a retrospective consecutive case series on eight patients (mean age 60) who had divergence insufficiency with an emphasis at distance.
“Each patient had a manifest esotropia at distance and smaller deviations at near that were typically esophoria,” Dr. Bothun said at the annual meeting of the American Association for Pediatric Ophthalmology and Strabismus (AAPOS).
The condition is so common in elderly adults, “I’d like us all to refer to it as adult onset idiopathic esotropia,” Joseph H. Calhoun, MD, said.
Adult onset idiopathic esotropia has long been noted by surgeons, but the etiology has been largely unknown, Dr. Bothun said.
In the study, six patients received prism therapy for a mean duration of 9 years. Patients’ mean preoperative esodeviation was 19.8 Δ at distance and 5.9 Δ at near, with a mean distance-near difference of 14.5 Δ.
After surgery was performed with bilateral medial rectus recessions of 3.5 mm to 4 mm, mean postop esodeviation dropped to 2.5 Δ at distance and 1.3 Δ at near. Patients were happy with results. Two patients required prism aid for the correction of postop diplopia.
Based on the results of this study, Dr. Bothun suggested that the subtle medial rectus restriction is “quite possibly” the etiology of the disorder.