Bimedial rectus recession measured from the limbus for congenital esotropia.

We reviewed the surgical results of bimedial rectus muscle recession measured from the limbus in 34 patients with congenital esotropia less than 1 year of age. The mean amount of recession was 10.8 mm. The procedure was successful (10 delta or less of horizontal deviation at 6 months) in 23 patients (68%). In all but one case failure was due to undercorrection. The success rate was 81% in the small-angle deviation group, compared with 29% in the large-angle deviation group (p less than 0.01). The average amount of deviation before surgery was 54.4 delta in the surgical success group and 65.0 delta in the undercorrection group (p less than 0.02). More surgery should be done in patients with larger deviations. Prospective randomized studies are needed to evaluate the efficacy of recession from the limbus versus recession from the insertion site.