Four-muscle surgery for infantile esotropia with V-pattern.
Inferior oblique overaction is frequently seen with infantile esotropia. In patients with infantile esotropia and V-pattern with moderate to large inferior oblique overactions, the oblique weakening can be combined with horizontal muscle surgery. Eighteen patients with infantile esotropia and V-pattern underwent bilateral inferior oblique recessions with bilateral 5.0-mm medial rectus recessions. Sixty-one patients with infantile esotropia underwent bilateral 5.0-mm medial rectus recessions alone. At 2 years' follow-up, the patients who had undergone medial rectus recessions alone showed, on average, 12.9 dioptres more reduction in esodeviation at distance and 13.4 dioptres more reduction at near in primary position than did those who had undergone 4-muscle surgery (P = 0.03). Only 2 of the 18 patients (11%) who had undergone 4-muscle surgery developed an A-pattern postoperatively.
D002648:Child; D002675:Child, Preschool; D004948:Esotropia / Q000150:complications / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy; D005139:Eyeglasses; D005403:Fixation, Ocular; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D009801:Oculomotor Muscles / Q000601:surgery*; D011184:Postoperative Period; D012030:Refractive Errors / Q000209:etiology; D013285:Strabismus / Q000601:surgery*