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Time and Factors Affecting the Direction of Re-drift in Essential Infantile Esotropia

Kun-Hoo Na, Yoonae A Cho, Seung-Hyun Kim

    Journal of Pediatric Ophthalmology and Strabismus
    |November 14, 2017
    PubMed

    Insights

    Postoperative re-drift in infantile esotropia differs between exotropic and esotropic types. Early esotropic drift contrasts with late exotropic drift, influenced by preoperative factors and refractive changes.

    Area of Science:

    • Ophthalmology
    • Pediatric Ophthalmology
    • Strabismus Surgery

    Background:

    • Infantile esotropia is a common childhood strabismus.
    • Surgical correction aims to align the eyes and improve binocular function.
    • Postoperative re-drift, including consecutive exotropia and recurrent esotropia, can occur after surgery.

    Purpose of the Study:

    • To investigate the distinct development patterns of postoperative re-drift in infantile esotropia.
    • To identify associated factors contributing to consecutive exotropia and recurrent esotropia.
    • To analyze the timing and predictors of different types of re-drift following surgical intervention.

    Main Methods:

    • A cohort of 112 patients with infantile esotropia, operated on before age 3, was retrospectively analyzed.
    • Surgical outcomes were categorized into consecutive exotropia (>8 PD exodeviation), recurrent esotropia (>8 PD esodeviation), and monofixation syndrome (≤8 PD deviation).
    • Occurrence rates, onset times, and associated factors of re-drift were evaluated using statistical analysis, including multinomial logistic regression.

    Main Results:

    • At a mean follow-up of 9.5 years, 33.0% developed consecutive exotropia and 38.4% developed recurrent esotropia.
    • Recurrent esotropia primarily occurred within the first postoperative year (76.7%), while consecutive exotropia developed gradually over 10 years.
    • Preoperative fixation preference and myopic progression rate predicted consecutive exotropia, whereas early postoperative esodeviation angle increase correlated with recurrent esotropia.

    Conclusions:

    • Significant differences exist in the temporal patterns of exotropic versus esotropic re-drift after infantile esotropia surgery.
    • Preoperative assessment of fixation preference and refractive status, along with close postoperative monitoring, are crucial for predicting surgical outcomes.
    • Understanding these distinct patterns aids in managing and optimizing long-term results for infantile esotropia.
    Abstract

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