Surgical Outcomes of Medial Rectus Recession and Lateral Rectus Resection for Large-angle Deviations of Acute Acquired Concomitant Esotropia

Purpose: This study aimed to evaluate the surgical outcomes of unilateral medial rectus recession and lateral rectus resection(R&R) for patients with large-angle deviations of acute acquired concomitant esotropia (AACE) without a neurologicaldisease. Further, we have also suggested the surgical dosage of R&R for large-angle deviations of AACE. Methods: This was a retrospective study of patients with AACE who underwent surgery and followed up after surgery for atleast 6 months between September 2016 and March 2020. Among them, patients with ocular deviations of ≥30 prism diopters(PD) who underwent unilateral R&R were included. Results: Seventeen patients with AACE were enrolled in this study (mean age, 23.5 years; four females). The mean amount ofdeviation was 40.00 PD at distance and near (range, 30–55 PD). Fifteen patients (88.2%) had myopia. The mean interval betweenthe initial visit and surgery was 7.7 months (range, 4–20 months). All included patients had resolved diplopia after thesurgery. Most patients with decreased stereoacuity displayed stereoacuity recovery after surgical treatment. At the final visit(mean follow-up period, 12.8 months), the mean angle of esodeviation was 0.82 PD (range, 6–0 PD) at distance and 0.47 PD(range, 4–0 PD) near. No patient displayed over-correction or adduction limitations in the operated eye. Conclusions: The unilateral R&R procedure presented favorable surgical outcomes for patients with large-angle deviations ofAACE. These results and proposed surgical dosage guidelines may be useful for surgeons in planning the surgical treatment oflarge-angle deviations of AACE.