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Monocular surgery for large-angle esotropias: review and new paradigms

The primitive strabismus surgeries, myotomies and tenotomies, were performed simply by sectioning the muscle or its tendon without any suture. Such surgeries were usually performed in just one eye both in small and in large angles with not really predictable results. In 1922, Jameson introduced a new surgery technique using sutures and fixing the sectioned muscle to the sclera, increasing surgery predictability. For the esotropias he carried out no more than 5 mm recession of the medial rectus, which became a rule for the surgeons who followed him, which made it impossible from then on to correct largeangle esotropias with a monocular surgery. Rodriguez-Vásquez, in 1974, exceeded the 5 mm parameter by proposing large recessions of the medial recti (6 to 9 mm) to treat the Ciancia syndrome with good results. The authors revised the literature year after year with the purpose of comparing the several works and concluded that monocular recession-resection surgery may be a feasible option for the surgical treatment of large-angle esotropias.

Strabismus; Strabismus; Esotropia; Oculomotor muscles; Visual acuity; Ophthalmologic surgical procedures


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