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Cohort studyJournal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus · 2026

Long-term outcomes of medial rectus muscle recession for various types of esotropia.

Yeji Moon, Hye Jun Joo, Seong-Joon Kim

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OphthalmologyCohort study

Just over half of children had lasting eye alignment success after esotropia surgery.

Long-term outcomes of medial rectus muscle recession for various types of esotropia.

Yeji Moon … Seong-Joon Kim

Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus · 2026

Purpose

To evaluate the long-term outcomes of medial rectus muscle recession for various subtypes of esotropia and to identify preoperative factors associated with surgical success and postoperative alignment stability.

Methods

This retrospective cohort study included pediatric patients (<15 years of age) who underwent unilateral or bilateral medial rectus muscle recession for infantile esotropia (infantile esotropia), partially accommodative esotropia (partially accommodative esotropia), acquired nonaccommodative esotropia (acquired nonaccommodative esotropia), or neurologic esotropia (neurologic esotropia), with a minimum postoperative follow-up of 3 years.

n = 344 patients

54%

Results

54%

over half kept eyes aligned years after surgery, without needing further correction

n = 344 patients

More results

Mean age at surgery was 3.4 ± 2.2 years.

Partially accommodative esotropia demonstrated the lowest overcorrection rate (15%) but a progressive increase in recurrence over time.

Younger age at onset, larger deviation angle, and presence of amblyopia were significantly associated with overcorrection.

More results

Postoperative sensory function was poorer in overcorrected patients, with only 11% achieving stereopsis better than 140 arcsec.

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Conclusion · 1 of 2

Overcorrection increased over time across all esotropia types, particularly in infantile esotropia and neurologic esotropia. partially accommodative esotropia patients also exhibited an increase in undercorrection/recurrence over time.

Conclusion · 2 of 2

Our findings underscore the need for individualized surgical strategies and extended follow-up, especially for patients with neurological impairments, abnormal binocular function, or accommodative components, to ensure stable alignment over time.

Long-term outcomes of medial rectus muscle recession for various types of esotropia.

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