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Relationship between stereopsis outcome and timing of surgical alignment in infantile esotropia
Teiji Yagasaki1, Yoshimi Yokoyama2, Makiko Tsukui2
1Yagasaki Eye Clinic, Ichinomiya, Japan; Department of Ophthalmology, Japan Community Health Care Organization Chukyo Hospital, Nagoya, Japan.
Insights
Early surgical intervention for infantile esotropia improves stereopsis outcomes. Very early surgery, before 8 months, offers the best chance for developing binocular vision and depth perception.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Strabismus Surgery
Background:
- Infantile esotropia is a common condition requiring timely management.
- The timing of surgical alignment is crucial for visual development, particularly stereopsis.
- Optimal surgical timing for infantile esotropia remains a subject of investigation.
Purpose of the Study:
- To investigate the relationship between the timing of surgical alignment and stereopsis outcomes in infantile esotropia.
- To compare binocular responses and stereopsis in patients undergoing surgery at different ages.
Main Methods:
- Retrospective analysis of medical records of 76 patients with infantile esotropia operated by age 8.
- Patients categorized into three groups based on age at surgery: very early (≤8 months), early (>8 to ≤24 months), and late (>24 months).
- Comparison of binocular response and stereopsis between the surgical timing groups.
Main Results:
- Very early surgery (≤8 months) showed significantly higher rates of binocular response (96%) and stereopsis (77%) compared to early and late surgery groups.
- A significant correlation was found between earlier age at surgery and improved stereopsis outcomes.
- Late surgery (>24 months) was associated with significantly lower rates of binocular response (50%) and stereopsis (13%).
Conclusions:
- Earlier surgical intervention in infantile esotropia is associated with better binocularity.
- Very early surgery (≤8 months) may enhance the potential for postoperative stereopsis.
- While early surgery is beneficial, spontaneous resolution of esotropia in some infants should be considered.
Purpose:
To clarify the relationship between stereopsis outcome and timing of surgical alignment in infantile esotropia.
Methods:
The medical records of otherwise healthy patients with infantile esotropia who underwent surgery by 8 years of age were divided into the following groups according to age at time of surgery: very early surgery (≤8 months), early surgery (>8 to ≤24 months) and late surgery (>24 months). Binocular response and stereopsis were compared between groups.
Results:
A total of 76 patients were included: 22 in the very early group, 30 in the early group, and 24 in the late group. Binocular response at near was found in 96% of the very early group and in 80% of the early group, significantly higher than the 50% of the late group (P < 0.001 and P < 0.05 [Dunn test], resp.). Stereopsis was present in 77% of the very early group, significantly higher than the 20% of the early group and 13% of the late group (P < 0.001 [Dunn test]). A significant correlation was also found between age (months) at surgery and stereopsis (seconds) outcome (logarithmic fit: y = 2539.4ln(x) + 147.2; R2 = 0.2691; P < 0.001).
Conclusions:
In this study cohort, earlier surgery was associated with better binocularity in patients with infantile esotropia. Our results suggest that very early surgery, at ≤8 months, can improve the chance for postoperative stereopsis, with the caveat that some infants might have had spontaneous esotropia resolution.
