Medial Rectus Fenestration versus Medial Rectus Recession in Treatment of Partially Accommodative Esotropia

Background: This study was conducted at the Ophthalmology Department, Faculty of Medicine, Zagazig University to compare medial rectus (MR) muscle fenestration with MR muscle recession in treatment of partially accommodative esotropia. Methods: The study included 28 patients with partially accommodative esotropia with angle of de-viation 15-40∆ randomly allocated into 2 groups. Pre-operatively, all patients underwent history tak-ing and ophthalmological examination. Patients in group (1) underwent bilateral MR recession while patients in group (2) underwent bilateral MR fenestration. Results: There was no significant difference between the 2 groups as regard sex, age, BCVA, pre and post operative angle of deviation at one month. Post-operative angle at 6 months was significantly higher among fenestration group. Pre-operative angle was reduced after 6 months by 26 prism diop-ters (PD) in recession group and by 22 PD in fenestration group. MR fenestration takes less operative time with mean 14.07 ± 1.33 minutes than the MR recession with mean 24.50 ± 3.25 minutes. Surgi-cal success at six months was 92.9% for recession and 57.1% for fenestration with statistically signifi-cant difference. Mean dose response (MDR) was significantly lower (1.99) in the MR fenestration group than in MR recession group (2.81). Conclusion: Although medial rectus recession was superior in many of the studied items, there are advantages of the fenestration technique, including being an easy sutureless procedure and taking less time. Our recommendation is to increase the amount of fenestration to be 2 mm more than the amount of recession and to have longer follow up periods.