Random dot stereoacuity following surgical correction of infantile esotropia

Surgical correction of infantile esotropia prior to age 2 is associated with a higher prevalence of fusion and stereopsis than surgical correction after 2 years of age. The advantages and disadvantages of surgical intervention at the early or late end of this window have been debated in the literature. In the present study, random dot (RD) stereoacuity outcomes were evaluated in order to determine whether a binocular sensory benefit is associated with early or late surgery. Participants were 73 healthy children enrolled in a prospective study of visual development in infantile esotropia. All children had initial surgical correction at 5 to 16 months of age. RD stereoacuity was evaluated at approximately 5 years of age (59.7 +/- 14.9 months). Overall, 41.1% of children demonstrated RD stereopsis. The percentage of children demonstrating RD stereopsis was not significantly different among groups that were surgically corrected at 5 to 8 months (43.8%), 9 to 12 months (47.4%), and 13 to 16 months (31.8%). However, among those children who achieved RD stereopsis, the prevalence of foveal (< 60 sec) or macular (61 to 200 sec) stereoacuity was significantly higher among those who had surgery at 5 to 8 months (42.9%; Z = 2.06, p < 0.02) or 9 to 12 months (55.6%; Z = 2.38, p < 0.009) than among those who had surgery at 13 to 16 months (0.0%). Although surgical correction of infantile esotropia during the first year of life is not associated with a higher prevalence of RD stereopsis, it is associated with better RD stereoacuity among those children who achieve stereopsis following surgery.