Observational studyJapanese journal of ophthalmology2025
Efficacy of the double-dose medial rectus muscle recession technique for sagging eye syndrome with esotropia of 10-prism diopters or less at distance.
Observational study in Japanese journal of ophthalmology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Convergence Insufficiency After Bilateral Medial Rectus Recession for Age-Related Distance Esotropia?American journal of ophthalmology · 2026Article
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8 authors.
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Abstract
purposeTo evaluate the surgical outcomes for small-angle sagging eye syndrome (SES) with a distance horizontal deviation of 10 Δ or less. STUDY
designRetrospective observational case series
methodsSix SES patients (mean age 77.2 ± 5.4 years, 4 men and 2 women) with distance esotropia of 10 Δ or less who underwent medial rectus recession at a single center in Shizuoka, Japan, from January 2020 to December 2023 were studied. Patients with high myopia (axial length ≥ 27 mm, refraction ≤-6 D) were excluded. Preoperative and postoperative alternate prism cover tests, Stereo Fly test (SFT) results, and presence of diplopia were assessed.
resultsThe patients underwent unilateral (n = 5) and bilateral (n = 1) medial rectus recession (6.4 ± 0.65 mm and 4.5 mm respectively), with 1 patient undergoing vertical muscle surgery. Preoperative/postoperative deviations (Δ) were distance horizontal +7.3 ± 2.4/-1.5 ± 2.5 (P = 0.035), distance vertical 2.2 ± 2.0/1.0 ± 1.3 (P = 0.42), near horizontal - 0.3 ± 3.2/-8.3 ± 6.4 (P = 0.058), and near vertical 2.0 ± 1.7/1.3 ± 1.8 (P = 0.59). The SFT (log) value was 1.99 ± 0.31/1.73 ± 0.21 (P = 0.056). Three patients experienced transient postoperative diplopia, which resolved over time. The diplopia improved in patients with concurrent vertical muscle surgery or a preoperative vertical deviation of 2 Δ or less (4 patients, 66.7%). However, those with a preoperative vertical deviation of 3 Δ or more (2 patients, 33.3%) required postoperative prism glasses.
conclusionMedial rectus recession in small-angle SES with a distance horizontal deviation of 10 Δ or less significantly improved distance horizontal deviation without inducing exotropia at near, with a trend towards improved stereopsis. Patients with a preoperative vertical deviation of 3 Δ or more had persistent postoperative vertical diplopia.
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