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Preferred postoperative alignment after congenital esotropia surgery.
A R Caputo1, S Guo, R S Wagner
1Eye Institute of New Jersey, Newark, 07107.
Annals of Ophthalmology
|July 1, 1990
Summary
Congenital esotropia surgery can lead to long-term exotropic drift. Even with initial success, many patients develop outward eye turning (exotropia) over time, indicating a need for ongoing monitoring.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Strabismus Surgery
Background:
- Congenital esotropia is a common misalignment of the eyes present from birth.
- Surgical correction aims to restore ocular alignment.
- Long-term outcomes and potential for deviation progression require investigation.
Purpose of the Study:
- To evaluate the long-term stability of ocular alignment after congenital esotropia surgery.
- To identify risk factors or patterns associated with the development of consecutive exotropia.
- To assess the prognostic value of early postoperative alignment on long-term outcomes.
Main Methods:
- Retrospective analysis of 117 patients with congenital esotropia undergoing muscle surgery.
- Inclusion criteria: orthotropic or within +/- 10 prism diopters (PD) at six months postoperatively.
- Follow-up for a minimum of three years, with some assessed up to five years.
Main Results:
- 86% of patients maintained alignment within +/- 10 PD at three years.
- 11% developed consecutive exotropia (>10 PD) by three years.
- 25% of patients assessed at five years had developed consecutive exotropia (>10 PD).
Conclusions:
- Satisfactory early postoperative alignment does not preclude long-term exotropic drift after congenital esotropia surgery.
- A trend towards progressive exotropia is observed over extended follow-up periods.
- Early alignment within 10 PD of esotropia may be a favorable indicator, as all patients with significant consecutive exotropia were orthotropic or mildly exotropic initially.