The surgical treatment of undercorrected esotropia: an evaluation of the effect of recession of the medial rectus muscle 13.5 mm from the limbus.

Nineteen patients with residual esotropia following conventional maximum horizontal recess-resect surgery were treated by further recession of the medial rectus muscle to a point 13.5 mm from the limbus. Six of these patients also underwent an 8-mm resection of the ipsilateral lateral rectus in addition to the medial recession. Eighteen of the patients achieved a good to excellent cosmetic result in the primary position. One patient was markedly overcorrected probably secondary to an unwarranted lateral rectus resection. Most of the patients showed some mild limitation of adduction, but this was generally not a significant cosmetic or functional defect. The degree of limitation seen was no greater than that which has been observed in similar patients treated by marginal myotomy. Recession of the medial rectus muscle 13.5 mm from the limbus seems to be a safe and effective method of treating surgically undercorrected esotropia.