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Long-term follow-up of esotropia surgery shows that many cases convert to phoria, with some developing exotropia. Regular check-ups are crucial for monitoring potential spontaneous changes in eye deviation after treatment.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Strabismus Surgery
Background:
- Infantile esotropia and acquired esotropia are common childhood eye conditions.
- Surgical intervention is often necessary for these conditions.
- Long-term outcomes and potential for deviation changes require further investigation.
Purpose of the Study:
- To evaluate the long-term outcomes of surgical treatment for infantile and acquired esotropia.
- To identify factors influencing the development of secondary exotropia after esotropia surgery.
- To understand the natural course of residual deviations post-surgery.
Main Methods:
- Retrospective analysis of 154 patients with infantile or acquired esotropia.
- Surgical treatment performed before the age of seven.
- Minimum follow-up period of five years, with some extending to ten years.
Main Results:
- 44% of infantile esotropia and 60% of acquired esotropia cases converted to phoria.
- 20% of patients developed postoperative exotropia.
- Age 8-10 years was a critical period for the shift from esotropia to exotropia.
- Spontaneous decrease in accommodative convergence with age is a key factor for secondary exotropia.
- Residual deviations decreased over time, and undercorrected esotropia resolved spontaneously.
Conclusions:
- Surgical outcomes for esotropia can evolve over time, with a significant rate of conversion to phoria and some developing exotropia.
- Age-related changes in accommodative convergence play a crucial role in the development of secondary exotropia.
- Long-term, regular follow-up care is essential for managing patients post-esotropia surgery to monitor for spontaneous deviation changes.
Abstract:
One hundred fifty-four cases of infantile esotropia and acquired esotropia surgically treated before the age of seven were followed for a minimum of five years. We found 44% of infantile esotropia and 60% of acquired esotropia were converted to phoria with 20% having postoperative exotropia. Eight to 10 years of age seemed to be the turning point from esotropia to exotropia. Spontaneous decrease of accommodative convergence with age seemed to be the most important causative factor in relation to secondary exotropia. Long-term follow-up revealed the residual angle of deviation decreased with time and undercorrected esotropia resolved spontaneously. Therefore, it is the responsibility of the surgeon to encourage his patients to return regularly for follow-up visits even ten years after surgery for possible spontaneous change of deviation.