Of 367 unilateral medial rectus recessions-lateral rectus resections and bilateral medial rectus recessions performed for childhood esotropia from 1960 through 1980, a total of 206 met the requirements for a comparative study. Preoperative and postoperative amblyopia was more prevalent in the recession-resection population and was attributed to the more common occurrence of monocular esotropia in patients undergoing recession-resection. Postoperative ocular alignment was better and the need for subsequent strabismus surgery was less in patients who initially underwent recession-resection. Because preoperative esotropia was found to be significantly greater in three of the four categories recorded among the bimedial recession population, we could not state that recession-resection was the "better" operation. Contrary to our previous recommendations for graded recessions, we now believe that maximal (5-mm) bimedial rectus recessions should be performed initially.