Esotropia Binocular Surgery Plan

Angle BMRc plus LRs* BLRs**
12-15 3 mm - 3.5 mm
16-20 3.5 mm - 4.5 mm
21-25 4 mm - 5.5 mm
26-30 4.5 mm - 6 mm
31-35 5 mm - 6.5 mm
36-40 5.5 mm - 7 mm
41-45 6 mm - 7.5 mm
46-50 6.5 mm - 8 mm
51-55 5 mm 5 mm -
56-60 5 mm 6 mm -
61-65 5 mm 7 mm -

(*)plus LRs used for large angles with BMRc
(**)lower by 1 mm when resecting laterals after BMRc of 6 or more
plus LRs = Lateral Rectus Resection used with BMRc

Congenital Esotropia Surgical Plan

Angle BMRc* LRs BLRs
30 10 mm - -
35 10.5 mm - -
40 11 mm - -
45 11.5 mm - -
50 12 mm - -
55 12.5 mm - -
60 11 mm 4 mm
65 11 mm 5 mm
70 11 mm 6 mm
75 11 mm 7 mm -
80 11 mm - 4 mm
90 11 mm - 5 mm
100 11mm - 6 mm

*Measured from limbus
BMRc = Bilateral medial rectus recessions
LRs = Single Lateral Rectus resection
BLRs = Bilateral Lateral Rectus resections

Congenital Esotropia Surgical Doses

(from William E. Scott)

Angle BMRc LRs BLRs
30 10 mm
35 10.5 mm
40 11 mm
45-50 11.5 mm
55 11 mm 4-5 mm
60 11 mm 6 mm
65 11 mm 7 mm
70 11 mm 4 mm
75 11 mm 5 mm
80 11 mm 6 mm
90-100 11 mm 7 mm

Medials are Measured from the limbus
BMRc= Bilateral medical rectus recessions
LRs= Lateral rectus resection
BLRs = Bilateral lateral rectus resections

Esotropia Surgical Doses

(from William E. Scott)

Angle BMRc LRs
12-15 3.0 mm
16-20 3.5 mm
21-25 4.0 mm
26-30 4.5 mm
31-35 5.0 mm
36-40 5.5 mm
41-45 6.0 mm
46-50 5.0 mm 5.0 mm
51-55 5.0 mm 6.0 mm
56-60 5.0 mm 7.0 mm

Esotropia: Recess/Resect Table

(from William E. Scott)

Angle MRc LRs
15 3.0 mm 4.0 mm
20 3.5 mm 5.0 mm
25 4.0 mm 6.0 mm
30 4.5 mm 7.0 mm
35-40 5.0 mm 8.0 mm
>40 see Cong ET Table

Esotropia: Binocular Surgery (two muscles)

(from Kenneth W. Wright)

Bilateral Medial Rectus Recessions or Bilateral Lateral Rectus Resections

Angle BMRc -or- BLRs*
15 3.0 mm 3.5 mm
20 3.5 mm 4.5 mm
25 4.0 mm 5.5 mm
30 4.5 mm 6.0 mm
35 5.0 mm 6.5 mm
40 5.5 mm 7.0 mm
50 6.0 mm 8.0 mm
60 6.5 mm
70 7.0 mm

*When lateral rectus resection is done for residual esotropia after large medial rectus recession (6.0 mm or larger), lower dose by a millimeter or more

Esotropia: Monocular Surgery (two muscles)

(from Kenneth W. Wright)

Angle MRc LRs
15 3.0 mm 3.5 mm
20 3.5 mm 4.0 mm
25 4.0 mm 5.0 mm
30 4.5 mm 5.5 mm
35 5.0 mm 6.0 mm
40 5.5 mm 6.5 mm
50 6.0 mm 7.0 mm
60 6.5 mm 7.5 mm
70 7.0 mm 8.0 mm