To compare the surgical outcomes of lateral rectus plication and resection techniques in patients with residual esotropia.

In this RCTstudy, a total of 57 patients with residual esotropia (31 females and 26 males) who were candidate for lateral rectus resection were included and randomized into plication (n=27) and resection (n=30) groups. The inclusion criteria were residual esotropia after uni- or bilateral medial rectus recession, or unilateral recession and resection (R&R). Subjects with a history of prematurity, lack of central fixation, extraocular muscle palsy, systemic, ocular disorders, follow up less than three months were excluded. A comprehensive ophthalmic examination was conducted preoperatively and at 1, 3 and 6 month follow-ups. Surgical success rate was considered postoperative eso- or exotropia ≤10pd.

Postoperative success showed no statistically significant difference between these two groups at all postoperative follow- ups of months 1, 3 and 6 (postoperative success rate at month 6 was 77.3% in plication and 85.2% in resection group). There was also similarity between dose responses of these groups in uni- or bilateral operations,

lateral rectus plication and resection had similar success rate results. Each surgical method could be selected according to surgeon's skill and comfort. We recommend plication method for patients with postoperative probability of anterior segment ischemia .