title: Pre-operative stability of infantile esotropia and post-operative outcome.
abstract: OBJECTIVE
  To define the prevalence and time course of significant changes in angle of deviation during the first months after the diagnosis of infantile esotropia and to determine whether long-term alignment and sensory outcomes differ when surgical alignment is performed on infants with stable vs unstable angles of deviation.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  setting: Institutional and clinical practice. patient population: Newly diagnosed patients with infantile esotropia (N = 208). observation procedure: Preoperative measurements of the angle of deviation on the initial visit and at approximate six-week intervals until surgery was performed. main outcome measures: Ocular alignment at six weeks, one year, and four years postoperative and stereoacuity at age five to nine years.
  
  
  RESULTS
  Overall, 57% of infants had an esodeviation on the second visit that was within 10 prism diopters (p.d.) of the deviation measured on the initial visit (stable group), 33% had an increase of 10 p.d. or more (unstable group), and 11% had a decrease of 10 p.d. or more. Among the 127 patients with additional preoperative visits, many switched between the stable and unstable categories during follow-up. Long-term, stable and unstable preoperative alignment groups had similar postoperative motor alignment, re-operation rates, rates of prescription of hyperopic, or bifocal spectacle correction and stereoacuity.
  
  
  CONCLUSIONS
  It may not be necessary to wait for a "stable" angle of esodeviation before surgery since both alignment and sensory outcomes were similar for stable and unstable groups.
authors.affiliation: Retina Foundation of the Southwest, Dallas, Texas 75231, USA. ebirch@retinafoundation.org
authors.forename: Eileen E
authors.initials: EE
authors.lastname: Birch
authors.forename: Joost
authors.initials: J
authors.lastname: Felius
authors.forename: David R
authors.initials: DR
authors.lastname: Stager
authors.forename: David R
authors.initials: DR
authors.lastname: Weakley
authors.forename: Rain G
authors.initials: RG
authors.lastname: Bosworth
mesh_terms: D017668:Age of Onset; D003867:Depth Perception / Q000502:physiology*; D004948:Esotropia / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D007223:Infant; D009801:Oculomotor Muscles / Q000503:physiopathology* / Q000601:surgery; D011184:Postoperative Period; D011300:Preoperative Care; D011446:Prospective Studies; D012086:Reoperation; D016896:Treatment Outcome; D015348:Vision, Binocular / Q000502:physiology*; D014792:Visual Acuity / Q000502:physiology*