Early surgical alignment for congenital esotropia

Area of Science:

• Ophthalmology
• Pediatric Ophthalmology
• Strabismus Surgery

Background:

• Congenital esotropia is a common form of strabismus in infants.
• Optimal timing for surgical intervention is crucial for visual development.
• Previous studies have explored the impact of surgical timing on outcomes.

Purpose of the Study:

• To determine the ideal age for surgical alignment in congenital esotropia.
• To investigate the relationship between age at surgery and the development of binocular vision.
• To provide evidence-based recommendations for surgical timing in congenital esotropia.

Main Methods:

• A clinical study involving 162 patients with congenital esotropia across three countries.
• Personal examination of patients by the author and compilation of results.
• Selection of 106 patients with reliable data, satisfactory alignment, and confirmed congenital esotropia by age one.

Main Results:

• No statistically significant difference in sensory testing results for patients aligned at 6, 12, or 24 months.
• Patients aligned after 24 months showed a significantly lower percentage with evidence of binocularity (P < 0.001).
• Surgical alignment before 24 months is associated with better outcomes for binocular function.

Conclusions:

• Surgical alignment for congenital esotropia should ideally be performed by 2 years of age.
• Delaying surgery beyond 24 months significantly diminishes the potential for achieving binocularity.
• Early surgical intervention is key to maximizing visual function in congenital esotropia.