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Why bilateral medial rectus recession fails? Factors associated with early repeated surgery

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Abstract

Background

To explore the risk factors for failure of bilateral medial rectus muscle recession (BMR) for esotropia.

Methods

We reviewed 171 consecutive patients with esotropia who underwent bilateral medial rectus muscle recession as a primary procedure from January 2009 to December 2011. Patients with infantile, partially accommodative and acquired esotropia were included. We compared patients who required more than one surgery to patients who only had one operation.

Results

A total of 171 patients (89 males, 52%, mean age 5.1 ± 6.0 years, range 0.4–51 years) fulfilled the inclusion criteria and comprised the study population. Mean follow-up period was 17.4 ± 15.5 months (range 1–65 months). A second strabismus surgery was performed in 17 (9.9%) cases within a mean time of 11.7 ± 9.2 months (range 0.4–27.7 months) from the initial surgery. Univariate analysis demonstrated that in patients younger than 1 year the odds ratio (OR) of failure was 4.00 (95% CI 1.12–14.35, p = 0.033) and for patients older than 7 years the OR of surgical failure was 3.27 (95% CI 1.10–9.76, p = 0.033). In addition, patients with esotropia > 60 prism diopters (PD) had a trend towards needing further surgery (OR = 3.91, 95% CI 0.93–16.44, p = 0.063). A multivariate model of regression revealed that age and angle of esotropia > 60 PD remained significant risk factors for requiring additional surgeries.

Conclusions

In our cohort of patients who underwent BMR for esotropia, a large angle of esotropia and age were associated with failure of surgery and need for reoperation.

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Funding

No grants or funding have been received for this study.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Weizmann St 6, 6423906, Tel Aviv, Israel

    Anat Bachar Zipori

  2. Pediatric Ophthalmology and Adult Strabismus Unit, Wolfson Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Oriel Spierer

  3. Ocular Motility Clinic, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, Australia

    Justin C. Sherwin & Lionel Kowal

  4. Department of Ophthalmology, Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia

    Justin C. Sherwin & Lionel Kowal

  5. Private Eye Clinic, East Melbourne, VIC, Australia

    Lionel Kowal

Authors
  1. Anat Bachar Zipori
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  2. Oriel Spierer
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  3. Justin C. Sherwin
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  4. Lionel Kowal
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Corresponding author

Correspondence to Anat Bachar Zipori.

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Ethical approval

The study was performed in accordance with the ethical standards of the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was initially performed as an audit; therefore, it did not specifically require an approval from an ethics committee.

Informed consent

Informed consent for surgery was obtained from all participants or their guardians prior to surgery.

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Bachar Zipori, A., Spierer, O., Sherwin, J.C. et al. Why bilateral medial rectus recession fails? Factors associated with early repeated surgery. Int Ophthalmol 40, 59–66 (2020). https://doi.org/10.1007/s10792-019-01152-2

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  • DOI: https://doi.org/10.1007/s10792-019-01152-2

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