Comparative study between bimedial recti Y-split recession versus bimedial recti combined recess–resect versus bimedial recti slanted recession for surgical management of infantile-onset esotropia

Background There are numerous weakening procedures on the medial recti muscle for the management of infantile-onset esotropia and include unilateral medial rectus recession, bilateral symmetric medial rectus muscle recession, bilateral scleral posterior fixation sutures with or without medial rectus recession (bilateral Faden operation), bilateral symmetric slanted recession of the medial rectus muscle, bilateral combined resection and recession of the medial rectus muscle. A new surgical intervention for weakening procedures on the medial recti muscle for the management of infantile-onset esotropia is bimedial recti Y-split recession. Objective The aim of this study was to assess the efficacy, safety and predictability of bimedial recti Y-split recession versus bimedial recti combined resection and recession versus bimedial recti slanted recession for the surgical management of infantile-onset esotropia. Patients and methods This study had a randomized and prospective design and included 45 patients with infantile esotropia. Patients were divided into three groups: Group A underwent bimedial recti Y-split recession. Group B underwent bimedial recti combined recess–resect. Group C underwent bimedial recti slanted recession. Results The results of both groups in this study were satisfactory; at least 60% of patients who underwent the Y-splitting procedure had a higher success rate and their results were more stable throughout the follow-up period. Conclusion This findings suggested that all groups in our study achieved a satisfactory success rate; patients who underwent Y-split recession had a higher success rate and their results were more stable throughout the follow-up visits until 1 year.