Bilateral versus unilateral surgical approaches for correcting non-alternating esotropia without vision disparity between the eyes

PurposeTo analyze the surgical results of bilateral medial rectus recession (BMR) versus unilateral medial rectus recession and lateral rectus resection (RNR) in patients with non-alternating esotropia associated with similar visual acuity in both eyes.MethodsData of suitable patients operated between 2010 to 2023 were collected from their electronic records immediately before surgery and during follow-up until the last available visit. Surgical success was defined as deviation of 10 prism diopters (PD) or less.Results473 patients had strabismus surgery for esotropia correction during the study period and 26 (5.5%) of them met the study's inclusion criteria: 12 (46.2%) in the RNR group and 14 (53.8%) in the BMR group. Final angles of deviations after RNR (distance 2.1 ± 2.9PD and near 3.6 ± 3.7PD) were not different than after BMR (distance 1.4 ± 2.4PD and near 4.0 ± 4.5PD, p = 0.54 and p = 0.80 respectively). Additionally, a similar success rate was achieved after both types of surgeries (100% for RNR and 92.8% for BMR, p = 0.35).ConclusionPatients with non-alternating esotropia and equal vision in both eyes who express concerns about the necessity of strabismus surgery on their non-deviating eye can achieve comparable outcomes following RNR performed exclusively in the deviating eye.