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Long term outcome of treated congenital/infantile esotropia: does early surgical binocular alignment restoring
1Ophthalmology Institute, La Plata, Argentina.jprietodtlink.com
Insights
Early binocular alignment in infantile esotropia can delay alignment loss and reduce oblique muscle overactions, even if initial alignment is not permanently maintained.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Strabismus Surgery
Background:
- Congenital/infantile esotropia is a common condition requiring early intervention.
- Surgical alignment aims to restore binocular function.
- Long-term outcomes and factors influencing stability are crucial.
Purpose of the Study:
- To evaluate the long-term stability of binocular alignment in congenital/infantile esotropia.
- To determine if early binocular vision influences the maintenance of alignment.
- To assess the impact of early alignment on secondary complications like oblique muscle overactions.
Main Methods:
- Retrospective review of 60 cases of congenital/infantile esotropia.
- Surgical binocular alignment performed before 30 months of age.
- Inclusion criteria: post-operative orthotropia (+/- 8 PD) with some binocular vision.
- Long-term follow-up (mean 14.7 years).
Main Results:
- Early alignment with some binocular cooperation does not guarantee permanent stability.
- Loss of alignment occurred at a later age in patients with prior binocular cooperation.
- The final percentage of alignment loss was comparable to non-qualified series.
Conclusions:
- Early surgical alignment with some binocular vision in congenital/infantile esotropia delays alignment loss.
- This approach appears to reduce the incidence of oblique muscle overactions.
- Long-term stability is influenced by the presence of early binocular cooperation.
Purpose:
To answer this important outcome question.
Subjects And Methods:
Retrospective review of a series of 60 qualified cases of congenital/infantile esotropia surgically binocularly "aligned" (= orthotropia +/- 8 PD) before 30 months of age and showing at one postoperative examination date at least some degree of (subnormal) binocular vision. Every patient was monitored over a very long postoperative followup period (mean 14.7 +/- 3.7 years).
Results:
Early binocular alignment with some binocular cooperation does not guarantee a stable outcome. However, even though the final percentage of patients losing "alignment" is similar to that observed in other non-qualified series of "aligned" congenital/infantile esotropias, the loss of "alignment" takes place at a much later age, if some binocular cooperation was present at some time in the past.
Conclusions:
For congenital/infantile esotropia, achieving, at an early age, binocular "alignment" with some degree of binocular vision delays the loss of "alignment" and seems to reduce the chance of developing oblique muscle overactions.
