Clinical characteristics and long-term postoperative results of infantile esotropia and myopia.
OBJECTIVE
To determine the short-term (6 month) and long-term (4 year) surgical results of infantile esotropia in a control group of 100 patients, as compared to a myopia (-2.0 to -5.0 diopters [D]) group of 13 patients and to a high-myopia (greater than -8.0 D) group of 14 patients.


METHODS
A retrospective chart review with selection according to inclusion criteria.


RESULTS
All 14 high-myopic patients (100%) achieved short-term unacceptable result of large-angle (greater than 20 prism diopters) deviation as compared to 29 (29%) and four (31%) of the patients in the control and myopia groups, respectively (P < 0.0001). Eighty (80%) of the patients in the control group and 10 (77%) in the myopia group achieved long-term favorable postoperative results of subnormal binocular vision, microtropia, or small-angle (less than 20 prism diopters) deviation, with no statistical differences between the two groups. In contrast, 10 (71%) of the patients in the high-myopia group achieved a final unacceptable result of large-angle deviation, as compared to 20 (20%) and three (23%) in the control and myopia groups, respectively (P < 0.0001). Persistent preoperative amblyopia was associated with a higher percentage of unfavorable surgical results and was more frequent in the high-myopia group (50%) as compared to the control group (14%) (P = 0.0004).


CONCLUSIONS
Careful attention must be directed preoperatively toward reversing amblyopia and correcting refractive errors because persistent amblyopia at the time of surgery was associated with a higher percentage of unacceptable postoperative large-angle deviation. The conventional amount of recession or resection of muscles should be increased in high-myopic cases with infantile esotropia, because less effect is produced per millimeter of recession/resection initially and, in the long-term, the constant stimulus to accommodative convergence apparently causes recurrent esotropia.
Shauly
Y
Y
Department of Ophthalmology, Rambam Medical Center, Haifa, Israel.
Miller
B
B
Meyer
E
E
D000065:Accommodation, Ocular; D000550:Amblyopia / Q000209:etiology / Q000503:physiopathology; D002675:Child, Preschool; D004948:Esotropia / Q000503:physiopathology / Q000601:surgery*; D005133:Eye Movements / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D009801:Oculomotor Muscles / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology; D011184:Postoperative Period; D012008:Recurrence; D012029:Refraction, Ocular / Q000502:physiology*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*