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Updated: Jun 4, 2026
Surgical Correction for Pediatric Epiblepharon and Trichiasis
Published on: July 8, 2025
Results of surgery for congenital esotropia
Pedro D Castro1, Alina Pedroso, Lourdes Hernández
1Ramón Pando Ferrer Ophthalmology Institute, Havana, Cuba. pedrocastro@infomed.sld.cu
Insights
Surgery effectively corrects congenital esotropia, a common eye misalignment in infants. Most patients achieved orthotropia (normal eye alignment) after procedures like bilateral medial rectus muscle recession.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Strabismus Surgery
Background:
- Congenital esotropia is an inward eye deviation presenting in the first six months of life.
- It can lead to amblyopia (reduced vision) in 30-50% of affected children.
- Early surgical intervention is crucial for successful treatment outcomes.
Purpose of the Study:
- To evaluate the surgical outcomes for congenital esotropia.
- To analyze patient data from a pediatric ophthalmology and strabismus service.
- To identify factors influencing surgical success in congenital esotropia.
Main Methods:
- A retrospective descriptive study reviewed 127 cases of congenital esotropia.
- Patients aged 1-18 years underwent surgery between January 2008 and May 2009.
- Data collected included age at surgery, amblyopia, fixation, refractive error, associated conditions, surgical technique, and deviation angles.
Main Results:
- The majority of cases (38.6%) were in children under 2 years old.
- Preoperative amblyopia was present in 62.4% of cases.
- Bilateral medial rectus muscle recession was the most common surgery (92.1%), correcting deviations to <10 prism diopters in 64.6% of patients postoperatively.
Conclusions:
- Surgical correction, particularly bilateral medial rectus muscle recession, is effective for congenital esotropia.
- Achieving orthotropia post-surgery significantly improves outcomes.
- Timely surgical intervention is key for managing this condition.
Introduction:
Congenital esotropia is a convergent deviation of the eyes when fixating on an object. It appears during the first six months of life and affects muscle structure and physiology, as well as the relation of the eyes with the environment, retinal relations and neural integration phenomena. Amblyopia develops in 30-50% of those affected. Timely surgery is effective in most cases.
Objective:
Describe surgical results in congenital esotropia cases treated in the Pediatric Ophthalmology and Strabismus Service of the Ramon Pando Ferrer Ophthalmology Institute in Havana between January 2008 and May 2009.
Methods:
A descriptive, retrospective study was carried out through review of 127 cases (aged 1-18 years, 55 male and 72 female) operated on for congenital esotropia between January 2008 and May [corrected] 2009. Variables used were: age at surgery, degree of preoperative amblyopia, type of fixation, refractive error, associated conditions, type of surgery performed and pre- and postoperative deviation angles.
Results:
The largest number of congenital esotropia cases were found in children <2 years old (38.6%). Before surgery, 37% of cases studied showed mild amblyopia; 22.8% moderate and 12.6% severe; 27.6% did not cooperate with visual acuity testing. With respect to fixation: 91.3% showed central fixation and 8.7% eccentric. Refractive errors found were: mild hyperopia (65.4%), moderate hyperopia (29.1%), and myopia (5.5%). Associated conditions were: overaction of the inferior oblique muscles (48%), latent nystagmus (16.5%), and dissociated vertical deviation (8.7%); no alterations were found in 26.8% of cases. The most frequently used surgical treatment was bilateral medial rectus muscle recession (92.1%). The most common preoperative deviation angle range was 31–40 prism diopters (PD) in 51.9% of patients; the postoperative deviation angle most commonly found after 12 months was <10 PD in 64.6% (orthotropia).
Conclusions:
Surgery, most commonly with medial rectus muscle resection, was effective in correcting congenital esotropia.
