Aims To determine the long-term outcome of prismatic correction in consecutive esotropia after bilateral lateral rectus (BLR) recession in children.

Methods Of 392 children with exotropia who received BLR recession, 44 developed consecutive esotropia. Five children underwent reoperation and 39 were treated with base-out prism glasses. The clinical characteristics and the efficacy of prismatic correction defined as the duration of prism treatment and the annual rate of decline in esodeviation angle (prism dioptres (PD)/year) after prismatic correction, clinical success rates based on postoperative alignment at distance, and the change in stereopsis were evaluated in the children who were treated with base-out prism glasses.

Results After a mean follow-up duration of 37.0±11.5 months, a successful motor outcome was achieved in 66.7% of patients and stereoacuity was improved or maintained in 79.2%. No patient lost stereopsis as a result of overcorrection. Prism glasses were prescribed an average of 7.4±8.1 months after surgery. During prism wear, the annual rate of decline in esodeviation was 4.2±6.7 PD. The mean duration of prism wear was 24.0±10.5 months and 82.1% were weaned off prisms at the last follow-up examination.

Conclusions In patients with consecutive esotropia after BLR recession, the angle of esodeviation continuously decreased and 82% were weaned off prism glasses after 3 years. Prismatic correction achieves good motor outcome while maintaining a favourable sensory status in most patients with consecutive esotropia after BLR recession.