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. 2022 Apr 18;15(4):661-665.
doi: 10.18240/ijo.2022.04.21. eCollection 2022.

Y-splitting medial rectus muscle and recession in treatment for convergence excess esotropia

Li-Juan Huang  1   2 , Yu-Yu Wu  1 , Ning-Dong Li  1   2   3   4
Affiliations

Y-splitting medial rectus muscle and recession in treatment for convergence excess esotropia

Li-Juan Huang et al. Int J Ophthalmol. .

Abstract

Aim: To evaluate the surgical outcome of medial rectus (MR) recession with Y-splitting procedure in treatment of esotropia with convergence excess.

Methods: Medical records were retrospectively reviewed for those patients who underwent surgical treatment for their convergence excess esotropia (CEET) between January 2018 and December 2020. Refractive error was examined by the equipment of the VS100 (Welch Allyn). The surgical approach was bilateral MR recession with Y-splitting. The amount of recession was calculated according to the deviation angle at distance. Ocular movement and ocular alignment at distance and near were evaluated pre- and post-operatively. Binocular sensory status was evaluated by the Bagolini striated glasses at near and distance, and by stereoacuity assessment at near using the Titmus test.

Results: Six patients with CEET were included in this study. Four of them were hyperopia and two of them were myopia. A mean of eso-deviation angle at distance had been changed from 27.3±13.02 prism diopters (PD) preoperatively to 1.83±1.60 PD postoperatively (P<0.05), while a mean of eso-deviation angle at near had been changed from 50.00±20.74 PD preoperatively to 6.83±0.98 PD postoperatively (P<0.05). Patients had obtained binocular vision postoperatively.

Conclusion: The surgical approach of Y-splitting MR and recession is effective in treatment of CEET.

Keywords: Y-splitting; convergence excess; esotropia.

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Figures

Figure 1
Figure 1. MR recession and Y-splitting
A: MR splitting to 15 mm posterior to the muscle insertion; B: Two halves of MR were recessed and reattached as Y-shape on the scleral surface.
Figure 2
Figure 2. Ocular alignments pre- and postoperation
A: CEET patient with myopia (case 3 in Table 1) underwent bilateral MR recession and Y-splitting. His esodeviation angle at near (A) was larger than that at distance (B), and was not able to reduce the near-distance disparity with bifocal lens (C) preoperatively. He had a orthophoria at both near and distance with or without the optical lens postoperatively (D, E, F).
See this image and copyright information in PMC

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