gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Asymmetric dosage in combined recession-resection procedure

Meeting Abstract

  • corresponding author T. Guthoff - Universitäts-Augenklinik Würzburg
  • J. Klink - Universitäts-Augenklinik Würzburg
  • W.D. Schäfer - Universitäts-Augenklinik Würzburg
  • H. Steffen - Universitäts-Augenklinik Würzburg

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogFR.10.09

The electronic version of this article is the complete one and can be found online at:

Published: September 22, 2004

© 2004 Guthoff et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.




We investigated whether asymmetric dosage in combined recession-resection procedure with a relation of 1:2 shows more effect on the distant angle than on the near angle and may therefore cause a postoperative convergence excess.


Retrospective analysis of 90 patients aged 4 to 13 with congenital esotropia, who underwent unilateral asymmetrically dosed combined recession-resection surgery between 2002 and 2003. We evaluated pre- and postoperative distant and near angles measured by the alternating prism cover test. In addition binocular functions and the amount of further eye muscle surgeries were investigated.


The amount of recession was 3,22 ±0,28 mm (mean ± standard deviation), the amount of resection 7,32 ±0,59 mm. The total amount was 10,54 ±0,63 mm. The relation of recession to resection was 1:2,29 ±0,28. Preoperative distant angles were C 23,11 ±5,67°, 3 days postoperatively distant angles decreased to C 4,99 ±5,35° and after 6 weeks to C 6,95 ±6,04°. Preoperative near angles were C 27,15 ±6,55° and decreased to C 8,35 ±5,85° 3 days post surgery and to C 10,94 ±6,76° at the 6 weeks control. Distant angles had diminished by 16,17 ±5,07 mm at the 6 weeks control, near angles by 16,21 ±6,15 mm. This corresponds to an effectivity of 1,53 ±0,47°/mm on distant angles and of 1,54 ±0,58°/mm on near angles. Simultaneous perception measured by striated lenses of Bagolini was postoperatively found in 18 patients for distant gaze, in 29 patients for near gaze. In 9 patients a second operation was performed several months later, in most cases a bilateral Fadenoperation on the medial rectus muscle.


Combined recession-resection procedure with a small amount of recession in regard to the amount of resection (relation 1:2,3) equally reduce distant and near angles and do not lead to a subsequent postoperative convergence excess.