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A randomised comparison of bilateral recession vs. unilateral recession-resection as surgery for infantile esotropia
  1. Jan Roelof Polling (j.polling{at}erasmusmc.nl),
  2. Marinus J C Eijkemans (m.eijkemans{at}erasmusmc.nl),
  3. Joachim Esser (joachim.esser{at}uni-essen.de),
  4. Ute Gilles (gillesute{at}web.de),
  5. Gerold H Kolling (gerold_kolling{at}med.uni-heidelberg.de),
  6. Elisabeth Schulz (e.schulz{at}uke.uni-hamburg.de),
  7. Birgit Lorenz (birgit.lorenz{at}uniklinikum-giessen.de),
  8. Peter Roggenkämper (proggenk{at}uni-bonn.de),
  9. Volkert Herzau (volker.herzau{at}med.uni-tuebingen.de),
  10. Alina Zubcov (zubcov{at}em.uni-frankfurt.de),
  11. Marcel P M ten Tusscher (mtusscher{at}hotmail.com),
  12. Dienke Wittebol-Post (d.wittebolpost{at}oogh.azu.nl),
  13. Gabriele C Gusek-Schneider (g.gusek-schneider{at}augen.med.uni-erlangen.de),
  14. Johannes R M Cruysberg (j.cruysberg{at}ru.nl),
  15. Huibert J Simonsz (simonsz{at}compuserve.com)
  1. Erasmus MC, Rotterdam, Netherlands
  2. Erasmus MC, Rotterdam, Netherlands
  3. Zentrum für Augenheilkunde, Universitätsklinikum Essen, Germany
  4. Eye Clinic / Ophthalmological Clinic of the University Medical Center, Freiburg, Germany
  5. Augenklinik der Universität Heidelberg, Germany
  6. Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Augenheilkunde, Germany
  7. Dept of Paediatric Ophthalmology,Strabismology and Ophthalmogenetics, Universitaetskl. Regensburg, Germany
  8. Universitäts-Augenklinik Bonn, Germany
  9. Universitäts-Augenklinik, Tübingen, Germany
  10. Zentrum der Augenheilkunde, Johann Wolfgang Goethe-Universität Frankfurt, Germany
  11. AZM, Departement of Ophthalmology, Maastricht, Netherlands
  12. UMC Utrecht, Ophthalmology, Netherlands
  13. Universitätsklinikum, Augenklinik, Erlangen, Germany
  14. Department of Ophthalmology, University Medical Centre Nijmegen, Netherlands
  15. Erasmus MC, Rotterdam, Netherlands

    Abstract

    Objective: Infantile esotropia, a common form of strabismus, is treated either by bilateral recession (BR) or unilateral recession-resection (RR). Differences in degree of alignment achieved by these two procedures have never been examined in a randomised controlled trial.

    Design: Controlled, randomised multicenter trial.

    Setting: 12 University clinics.

    Participants and intervention: We randomly assigned 124 patients to either BR or RR.

    Main outcome measure: Alignment assessed as the variation of the postoperative angle of strabismus during alternating cover.

    Results: The mean postoperative angle of strabismus at distance was +2.3° (SD±5.1) for BR and +2.9° (SD±3.5) for RR (P=0.46 for reduction of the angle and P=0.79 for the within-group variation). The mean reduction of the angle of strabismus was 1.41 degree per millimetre of muscle displacement (SD±0.45) for RR and 1.47 (SD±0.50) for BR (P=0.85 for reduction of the angle and P=0.22 for the within-group variation). Alignment was associated with postoperative binocular vision (P=0.001) in both groups.

    Conclusions: We did not find a statistically significant difference between BR and RR as surgery for infantile esotropia.

    Trial registration: Clinical trials NCT 00304577.

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