BACKGROUND: Convergence excess esotropia (EC) can be an additional component in all forms of strabismus. The most favourable prognosis is found in those cases where EC is associated with microtropia or bifoveal fusion, due to a better binocular potential. METHODS: 50 non selected cases were entered into the study and divided into two groups (Group A: EC with microtropia; Group B: EC with bifoveal fusion). All the patients were followed at the Lausanne Strabismus Unit and all cases underwent a bilateral medial rectus posterior fixation (Cüppers' Faden operation) placed at 13 mm from the original insertion. RESULTS: In Group A, the average reduction of angle of strabismus was 25 delta for near fixation, 20 delta in Group B. In both groups, the average decrease in angle for distance fixation was 6 delta. In Group A, 75% of cases gained some binocularity post-operatively, not only for distance but also for near fixation. In Group B, all the patients showed a normal response on the Lang stereotest post-operatively. CONCLUSIONS: In both groups of this study, a bilateral medial rectus retroequatorial myopexy was a satisfactory alternative for those patients who refused to wear bifocal glasses.