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The relationship between preoperative alignment stability and postoperative motor outcomes in children with esotropia
1, Stephen P Christiansen, Danielle L Chandler
1Jaeb Center for Health Research, Tampa, Florida 33647, USA. pedig@jaeb.org
Insights
Preoperative alignment stability did not significantly impact postoperative outcomes in children undergoing esotropia surgery. Further research is needed due to the small sample size, but initial findings suggest similar results for stable versus unstable alignment.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Strabismus Research
Background:
- Esotropia is a common form of strabismus in children.
- Preoperative alignment stability is a potential factor influencing surgical outcomes.
- Understanding this relationship can guide surgical planning and patient counseling.
Purpose of the Study:
- To investigate the association between preoperative alignment stability and postoperative motor outcomes in pediatric esotropia surgery.
- To compare alignment outcomes based on the classification of preoperative alignment (stable, uncertain, unstable).
Main Methods:
- An observational study included 167 children under 6 years with infantile or acquired esotropia.
- Preoperative alignment was monitored for 18 weeks to classify stability.
- Postoperative alignment was assessed at 6 weeks and 6 months using prism measurements and alternate cover test.
Main Results:
- No significant differences in median postoperative deviation were observed between stable and unstable preoperative alignment groups for both infantile and acquired esotropia at 6 weeks and 6 months.
- For infantile esotropia, 6-month deviations were 1(Delta) for stable/unstable and 9(Delta) for uncertain.
- For acquired esotropia, 6-month deviations were 8(Delta) for stable, 4(Delta) for uncertain, and 6(Delta) for unstable.
Conclusions:
- Postoperative alignment in children with esotropia appears similar regardless of preoperative alignment stability.
- Findings suggest that preoperative stability may not be a critical determinant of surgical success.
- Caution is advised due to the small sample size, necessitating further investigation.
Purpose:
To examine the effect of preoperative alignment stability on postoperative motor outcomes in children who underwent surgery for esotropia.
Methods:
One hundred sixty-seven subjects (68 with infantile esotropia and 99 with acquired esotropia) aged less than 6 years had surgery after completing 18 weeks of follow-up as part of an observational study. Preoperative alignment was classified as stable, uncertain, or unstable, based on measurements taken at baseline and every 6 weeks for 18 weeks. Distance alignment measured by prism and alternate cover test was compared among stability classification groups at 6 weeks and 6 months after surgery.
Results:
Among subjects with infantile esotropia, median 6-week postoperative deviation was 2(Delta), 6(Delta), and 2(Delta) for subjects with stable, uncertain, and unstable preoperative alignment, respectively (p = 0.73 for stable vs unstable). Median 6-month postoperative deviation was 1(Delta), 9(Delta), and 1(Delta) for stable, uncertain, and unstable, respectively (p = 1.00 for stable vs unstable). Among subjects with acquired esotropia, median 6-week postoperative deviation was 6(Delta), 4(Delta), and 4(Delta) for subjects with stable, uncertain, and unstable preoperative alignment, respectively (p = 0.69 for stable vs unstable). Median 6-month postoperative deviation was 8(Delta), 4(Delta), and 6(Delta) for stable, uncertain, and unstable, respectively (p = 0.22 for stable vs unstable).
Conclusions:
Postoperative alignment at 6 weeks and 6 months appears similar in children with stable versus unstable preoperative esotropia. Nevertheless, our finding should be interpreted with caution due to small sample size.