Correction of large variable angle infantile esotropia by de Decker’s Faden surgery versus large bi-medial recti recession

This study aims to compare the outcomes of the large bi-medial rectus recession (BMR) versus recession with de Decker’s modification of Faden technique for the treatment of large angle infantile esotropia (ET) with angle variability in Egyptian patients. Fifty children diagnosed with infantile ET were separated into two groups: group A, which had large BMR (6–8 mm), and group B, which had BMR with de Decker’s modification of the Faden surgery. All participants underwent a comprehensive ocular examination, which included measuring deviation angles, and fulfilled the inclusion criteria of the study. Surgical procedures were conducted under general anesthesia. Patient follow-up was conducted on day 1, week 1, months 1, 3, and 6 following the surgery. The average age distribution for group A was 20.43 months with a SD of 13.44 months, whereas for group B it was 21.40 months with a SD of 12.35 months. The average preoperative maximum angle of strabismus recorded for group A was 32.3±8.154°, while for group B it was 33.6±7.0297°. The average surgery duration for group A was 25.06 min, whereas for group A it was 45 min. By the end of the follow-up period, 80% of patients in group A and 84% of patients in group B achieved good outcomes, i.e. ET or Exotropia less than 10°. In conclusion, the findings of this study indicate that both techniques yield similar outcomes in correcting large variable angle infantile ET.