A prospective study of alternating occlusion before surgical alignment for infantile esotropia: one-year postoperative motor results.
BACKGROUND
Alternating occlusion before surgical alignment has been suggested by some strabismologists as a possible method to enhance the treatment of infantile esotropia.


OBJECTIVE
This report presents 1-year outcome results of a prospective trial of patients with infantile esotropia who were assigned randomly to alternating occlusion or control groups.


METHODS
Forty-four patients with infantile esotropia were measured at entry into the study, at the time of surgery, at 6 weeks, and 1 year postoperatively. Alternating occlusion was full time and symmetric for those with no amblyopia but asymmetric for those with amblyopia. The control group that did not receive alternating occlusion had occlusion for amblyopia only. Initial surgeries were performed when the patients were between the ages of 6 and 13 months.


RESULTS
Overall, the patients showed an increase of 9.14 prism diopters (PD) during a mean preoperative follow-up of 4.2 months. Seventy-five percent of all patients were aligned by the initial surgery. Ninety-one percent of those patients aligned within 10 PD at 6 weeks also were aligned 1 year postoperatively. The results were similar for the alternate occlusion group and the control group.


CONCLUSIONS
In our sample of patients, alternating occlusion does not detectably alter the increase in angle of deviation between the dates of entry and the date of the initial surgical alignment procedure, nor does it influence the postoperative alignment at 6 weeks or at 1 year.
Ing
Malcolm R
MR
The Smith-Kettlewell Eye Research Institute, San Francisco, California, USA. malcolmingmd@hotmail.com
Norcia
Anthony
A
Stager
David
D
Black
Bradley
B
Hoffman
Robert
R
Mazow
Malcolm
M
Troia
Sebastian
S
Scott
William
W
Lambert
Scott
S
D004948:Esotropia / Q000503:physiopathology / Q000628:therapy*; D005133:Eye Movements / Q000502:physiology*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D009801:Oculomotor Muscles / Q000503:physiopathology* / Q000601:surgery; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D012683:Sensory Deprivation; D016896:Treatment Outcome