Bimedial Recession in High AC/A Esotropia

Esotropia with high AC/A may be corrected by bimedial recessions of 4 to 5 mm without fear of overcorrection at distance. Small angle deviations at distance were not overcorrected and should not deter correcting large near deviations. The near deviations should be at least 20 prism diopters of esotropia. Smaller deviations were undercorrected or unchanged by this surgery. Potential exotropia producing factors must be avoided in patient selection. Recession of less than 4 mm proved ineffective regardless of the deviation, while bilateral recession of 4 or 5 mm produced accurate correction. The procedure was equally effective for constant and intermittent deviations. The relationship of the preoperative deviations to the amount of correction obtained per millimeter of recession was analyzed. This may be an accurate method of predicting surgical results.