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KMID : 0360220140550020271
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Journal of the Korean Ophthalmological Society
2014 Volume.55 No. 2 p.271 ~ p.277
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What to Predict Favorable Long-Term Sensory Outcome after Surgery for Infantile Esotropia?
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Lee Jong-Hwan
Paik Hae-Jung
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Abstract
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Purpose: To analyze pre- and post-operative factors associated with favorable long-term sensory outcome after surgical correction for infantile esotropia.
Methods: This study retrospectively examined 40 patients with infantile esotropia who underwent surgery from January 2000 to December 2010. Clinical characteristics analyzed included age at onset, age at surgery, mean preoperative deviation, amblyopia on initial visit, other associated strabismus (Inferior oblique overaction (IOOA), dissociated vertical deviation (DVD), latent nystagmus), initial and subsequent postoperative motor alignment at 1-week and 2-year follow-up, recurrence rate, and stereopsis. Long-term sensory outcome was categorized as favorable (≤400 arcsec) or unfavorable (>400 arcsec).
Results: The mean follow-up period was 92.53 ± 46.46 months. There were 19 patients (47.5%) in the favorable group and 21 (52.5%) in the unfavorable group. There were no statistically significant differences between the groups with respect to age at onset or surgery, presence of amblyopia, and prevalence of IOOA and DVD, latent nystagmus, or initial postoperative alignment at 1-week. There was a tendency towards worse binocularity with larger preoperative angles of esodeviation, but it was not significant. Binocularity was significantly higher among those who had surgery at age ≤24 months than at age >24 months. Orthotropic alignment within ±10 PD at 2-year follow-up was 68.4% in the favorable group and 38.1% in the unfavorable group. Reoperation was performed on 8 patients (38.1%) in the unfavorable group and no patients (0.0%) in the favorable group.
Conclusions: Surgical correction of infantile esotropia within the first 2 years of life and maintenance of orthotropic alignment within ±10 PD without additional surgery with a minimum follow-up of 2 years may be associated with favorable long-term sensory outcome in infantile esotropia.
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KEYWORD
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Age at surgery, Binocularity, Infantile esotropia, Postoperative alignment, Reoperation rate
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