Three-muscle surgery for infantile esotropia in children younger than age 2 years.
OBJECTIVE
To review the long-term outcome of infants undergoing three-muscle surgery for infantile esotropia.


METHODS
Surgical records of 10 patients with esotropia > or = 55 prism diopters (PD) who underwent three-muscle surgery for large-angle infantile esotropia were reviewed. Outcome measures included over- or undercorrection, need for additional surgery, and amount of deviation at last follow-up.


RESULTS
Mean age at initial surgery was 13 months. Mean preoperative deviation was 62.5 PD of esotropia. A single surgery was associated with satisfactory horizontal alignment in only three (30%) patients at last follow-up (mean, 37.1 months; range, 8-70 months). Esotropia was undercorrected in one (10%) and overcorrected in six (60%) patients, all of whom required additional surgery. One patient with satisfactory horizontal alignment required an additional procedure to correct a right hypertropia causing a left face turn.


CONCLUSIONS
In contrast to older children and adults, three-muscle surgery may be inappropriate for infants with large-angle esotropia due to a large overcorrection rate. This controversy may benefit from a prospective study.
Tennessee Lions Eye Center, Vanderbilt Children's Hospital, Nashville, Tennessee, USA.
Olga V
OV
Minkoff
Sean P
SP
Donahue
D004948:Esotropia / Q000601:surgery*; D006801:Humans; D007223:Infant; D009801:Oculomotor Muscles / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D012086:Reoperation; D012307:Risk Factors; D016896:Treatment Outcome; D015348:Vision, Binocular