title: Long-term results of esotropia surgery in children with developmental delay.
abstract: OBJECTIVE
  To assess the long-term results of esotropia surgery in children with developmental delay who were operated on with reduced surgical dosages.
  
  
  METHODS
  This was a retrospective analysis of children with developmental delay who had undergone surgery for esotropia during a 16-year period. The pre- and postoperative angle of deviation was calculated for each subject as the mean of distant and near angles measured by a cover test or the Krimsky measurement. The main outcome measure was surgical success, categorized as esotropia or exotropia of ≤ 10(Δ).
  
  
  RESULTS
  The chart review identified 24 children who met inclusion criteria, with a mean age of 2.8 ± 2.5 years (range, 0.8-10 years). The mean angle of preoperative esotropia was 49.8(Δ) ± 13.3(Δ). All patients had bilateral medial rectus muscle recessions, with a mean surgical dosage of 5.1 ± 0.7 mm per muscle, on average 0.75 mm less than the standard amount. The average postoperative follow-up was 5.3 ± 3 years (range, 1-13 years). Surgical success was achieved in 9 of 24 children (37.5%) after one operation. Among the 15 failures, 10 (66.6%) were undercorrected, and 5 (33.3%) developed consecutive exotropia. Of these, 8 (53%) agreed to a second procedure. The overall surgical success rate for all patients after all procedures was 63%.
  
  
  CONCLUSIONS
  Although the initial success rate is low with reduced surgical amounts in children with developmental delays, and some children become exotropic on long-term follow-up, satisfactory results may be achieved with additional procedures.
authors.affiliation: Department of Ophthalmology, Tel-Aviv Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. zwilner@hotmail.com
authors.forename: Zohar
authors.initials: Z
authors.lastname: Habot-Wilner
authors.forename: Abraham
authors.initials: A
authors.lastname: Spierer
authors.forename: Irina S
authors.initials: IS
authors.lastname: Barequet
authors.forename: Tamara
authors.initials: T
authors.lastname: Wygnanski-Jaffe
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000150:complications*; D004948:Esotropia / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D005099:Exotropia / Q000209:etiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000209:etiology; D012029:Refraction, Ocular / Q000502:physiology; D012030:Refractive Errors / Q000534:rehabilitation; D012189:Retrospective Studies; D016896:Treatment Outcome