Surgical results after one-muscle recession for correction of horizontal sensory strabismus in children

Purpose: To report the success rates in children after one-muscle recession for sensory strabismus. Methods: The medical records of consecutive patients ≤18 years of age who underwent primary unilateral horizontal surgery for sensory strabismus measuring ≤30^Δ from 2004 to 2010 were retrospectively reviewed. Data collected included age at surgery, sex, length of follow-up, procedure performed, pre- and postoperative deviation, and treatment of associated vertical strabismus. Success was defined as a final deviation within 10^Δ of orthotropia. Results: A total of 33 patients (16 males) were included. Mean age at surgery was 5.2 years (range, 6 months to 17 years) and mean follow-up was 36 months (range, 6 months-7.4 years). Age at surgery (P = 0.37) and follow-up (P = 0.79) were comparable in patients with esotropia (n = 12) and exotropia (n = 21). Mean preoperative deviation was 23.7^Δ in the esotropia group and 24^Δ in the exotropia group (P = 0.875). Successful postoperative alignment was achieved in 76% of esotropic patients and 92% of exotropic patients (P = 0.379). Lateral rectus recessions resulted in a mean correction of 2.8^Δ/mm of recession compared to 3.0^Δ/mm for medial rectus recessions (P = 0.71). Conclusions: Advantages of one-muscle recession include a high success rate, few over-corrections, relatively short duration of surgery, and an intact muscle should reoperation be indicated.