Esotropias that totally resolve under general anesthesia treated exclusively with bilateral fadenoperation.
OBJECTIVE
Fadenoperation has been proven to be an efficient method to treat convergence excess because it treats medial rectus (MR) overaction. We wanted to evaluate its efficiency in esotropias that totally disappear under anesthesia, regardless of the amount of deviation in waking hours.


METHODS
Included were 122 successive cases of children of ages 3 to 16 years with esotropia that completely disappears under general anesthesia (GA), representing 26.25% of all patients with esotropia that had surgery between August 2002 and July 2004. They all received a fadenoperation (retroequatorial strapping) of both MR without recession with a 5/0 nylon suture.


RESULTS
Patients were evaluated between 27 and 51 months postoperatively. Mean initial deviation was 21 prism dioptres (PD) at distance and 31 PD at near fixation. Of the 122 cases, 102 (83.6%) showed stable postoperative deviation between +8 and -8 PD, 7 showed exotropias (< 20 PD), and 13 showed esotropias (< 20 PD). These results were found without correlation to preoperative angle of deviation, ametropia, age at surgery, or association with vertical surgery.


CONCLUSIONS
Our results suggest that fadenoperation of MR is an option to treat esotropias that disappear under anesthesia. The retroequatorial strapping we use seems safer than classical fadenoperation. We believe that the position of the eyes under GA should be considered for the surgical approach of esotropias.
Thouvenin
Dominique A
DA
Clinique Ophtalmologique Saint Nicolas, Toulouse, France. dr.thouvenin@wanadoo.fr
Sotiropoulos
Marie C
MC
Arné
Jean-Louis
JL
Fournié
Pierre R
PR
D000293:Adolescent; D000768:Anesthesia, General; D002648:Child; D002675:Child, Preschool; D004948:Esotropia / Q000503:physiopathology* / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D009801:Oculomotor Muscles / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures / Q000379:methods; D016896:Treatment Outcome