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Unilateral medial rectus recession for small-angle esotropia.

Ten patients with small-angle esotropia of 18 prism diopters or less were treated with a unilateral medial rectus recession of 5 mm. Nine of the ten cases considerably improved; one showed only minimal improvement. There were no overcorrections, but two cases did show lateral incomitance with a greater correction on gaze in the field of action of the recessed medial rectus muscle. Two patients became monofixators after the surgery. These had been patients with accommodative esotropia who had decompensated and had surgery for the nonaccommodative portion of the total esotropia. When indicated, the recession of one medial rectus muscle is a safe and predictable procedure for small-angle esotropia. An average correction of 11.6 prism diopters was obtained at distance and one of 11.3 prism diopters at near.