Article Text

Download PDFPDF
A randomised comparison of bilateral recession versus unilateral recession–resection as surgery for infantile esotropia
  1. J-R Polling1,
  2. M J C Eijkemans2,
  3. J Esser3,
  4. U Gilles4,
  5. G H Kolling5,
  6. E Schulz6,
  7. B Lorenz7,8,
  8. P Roggenkämper9,
  9. V Herzau10,
  10. A Zubcov11,
  11. M P M ten Tusscher12,
  12. D Wittebol-Post13,
  13. G C Gusek-Schneider14,
  14. J R M Cruysberg15,
  15. H J Simonsz1
  1. 1
    Department of Ophthalmology, Erasmus MC Rotterdam, Rotterdam, The Netherlands
  2. 2
    Department of Public Health, Erasmus MC Rotterdam, Postbus Rotterdam, The Netherlands
  3. 3
    Zentrum für Augenheilkunde, Universitätsklinikum Essen, Essen, Germany
  4. 4
    Eye Clinic/Ophthalmological Clinic of the University Medical Center, Freiburg, Germany
  5. 5
    Augenklinik der Universität Heidelberg, Heidelberg, Germany
  6. 6
    Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Augenheilkunde Martinistraße, Hamburg, Germany
  7. 7
    Department of Ophthalmology, Justus-Liebig-University Giessen, Giessen, Germany
  8. 8
    Department of Paediatric Ophthalmology, Strabismology and Ophthalmogenetics, Universitaetsklinikum Regensburg, Regensburg, Germany
  9. 9
    Universitäts-Augenklinik Bonn, Bonn, Germany
  10. 10
    Universitäts-Augenklinik, Tübingen, Germany
  11. 11
    Zentrum der Augenheilkunde, Johann Wolfgang Goethe-Universität Theodor-Stern-Kai 7, Frankfurt, Germany
  12. 12
    AZM, Department of Ophthalmology, Maastricht, The Netherlands
  13. 13
    UMC Utrecht, Ophthalmology, Utrecht, The Netherlands
  14. 14
    Universitätsklinikum, Augenklinik, Erlangen, Germany
  15. 15
    Department of Ophthalmology, University Medical Centre Nijmegen, Nijmegen, The Netherlands
  1. Professor H J Simonsz, Erasmus MC University Medical Center Rotterdam, Department of Ophthalmology, Postbus 2040, 3000 CA, Rotterdam, The Netherlands; simonsz{at}


Objective: Infantile esotropia, a common form of strabismus, is treated either by bilateral recession (BR) or by unilateral recession–resection (RR). Differences in degree of alignment achieved by these two procedures have not previously been examined in a randomised controlled trial.

Design: Controlled, randomised multicentre trial.

Setting: 12 university clinics.

Participants and intervention: 124 patients were randomly assigned to either BR or RR. Standardised protocol prescribed that the total relocation of the muscles, in millimetres, was calculated by dividing the preoperative latent angle of strabismus at distance, in degrees, by 1.6.

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

Results: The mean preoperative latent angle of strabismus at distance fixation was +17.2° (SD 4.4) for BR and +17.5° (4.0) for RR. The mean postoperative angle of strabismus at distance was +2.3° (5.1) for BR and +2.9° (3.5) for RR (p = 0.46 for reduction in the angle and p = 0.22 for the within-group variation). The mean reduction in the angle of strabismus was 1.41° (0.45) per millimetre of muscle relocation for RR and 1.47 (0.50) for BR (p = 0.50 for reduction in the angle). Alignment was associated with postoperative binocular vision (p = 0.001) in both groups.

Conclusions: No statistically significant difference was found between BR and RR as surgery for infantile esotropia.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Competing interests: None.

  • Funding: The Netherlands Society for Prevention of Blindness, Haags Oogheelkundig Fonds, Stichting Blindenhulp and the Rotterdamse Vereniging Blindenbelangen supported this study.

  • Ethics approval: Ethics approval was provided by the Medical Ethics Committee at the Erasmus MC.

  • Patient consent: Obtained from the parents.