INFANTILE ESOROPIA: MANAGEMENT RESULTS AND PROGNOSTIC FACTORS

Abstract

BACKGROUND:

Infantile esotropia is characterized by a significant deviation angle and a marked sensory perversion. Although the motor surgical results are satisfactory, the sensory results remain disappointing.

AIM:

Our work aims to describe the methods of surgical management, its motor and sensory results as well as its prognostic factors.

METHODS:

Retrospective study of 68 cases of infantile esotropia. All patients underwent a complete ophthalmologic examination and sensorimotor assessment. They were operated on, under general anesthesia, by the same surgeon. We assessed the motor and sensory results. The prognostic factors studied were age of onset, treatment delay, amblyopia severity, strabismus deviation angle, and presence of a vertical element.

RESULTS:

The mean minimum angle of deflection was 38.6 ± 13.2D. Inferior oblique muscle hyper action was noted in 73.5% and a dissociated vertical deviation in 5.8%. Bilateral medial rectus muscle recession was the most performed surgery (60.2% of cases). The overall success rate was 94.11%. No patient acquired stereoscopic vision. Multivariate logistic regression analysis showed that preoperative nail (p = 0.007), immediate postoperative outcome (p <0.001) and surgical dosage (p = 0.009) were associated with long-term motor success.

CONCLUSION:

The motor results of early esotropia surgery are generally satisfactory; the sensory results are often disappointing. Detecting poor prognostic factors improves operative results.