title: Essential infantile esotropia: postoperative motor outcomes and inferential analysis of strabismus surgery.
abstract: BACKGROUND
  The aim of this retrospective study is a long-term evaluation of postoperative motor outcomes and the inferential analysis of strabismus surgery in infant eyes with essential infantile esotropia.
  
  
  METHODS
  576 patients were compatible with the criteria: confirmed EIE diagnosis, angle ≥ 30 pD, absence of associated ocular anomalies, onset by 6 months of age, absence of hyperopia > 3 Diopters, operation before age 4. Preoperative deviation classes (30-40 pD, 41-59 pD, ≥ 60 pD) were established, different types of surgery were performed. Follow-up was conducted for 5 years after surgery. Longitudinal data were analyzed using general linear mixed models stratified according to the class of pre-operative deviation. A random intercept and a random slope with time (in months) was assumed with an unstructured within subject correlation structure for repeated measurements.
  
  
  RESULTS
  In patients with preoperative angle ≤ 40 pD, a significant interaction effect for intervention by time (F5,155.9 = 3.56, p = 0.004) and a significant intervention effect (F5,226.1 = 6.41, p < 0.001) on residual deviation were observed; only the intervention 5 showed a residual deviation inside the limits of a partial success. In Class 41-59, a significant interaction effect for intervention by time (F4,166.7 = 5.16, p = 0.001), intervention (F4,178.1 = 2.48, p = 0.046) and time (F1,174.6 = 9.99, p = 0.002) on residual deviation were observed; intervention 7 had the highest degree of stability showing an outcome within the range of a partial success. In Class ≥ 60 pD no significant effect for intervention (F4,213.9 = 0.74, p = 0.567), time (F1,169.5 = 0.33, p = 0.569) or intervention by time (F4,160.9 = 1.08, p = 0.368) on residual deviation was observed; intervention 3,6 and 7 resulted in a residual deviation within the range of a partial success.
  
  
  CONCLUSIONS
  We suggest, where possible, a two-horizontal muscles approach in small angle EIE, while a multiple muscles surgery in large angle EIE.
authors.affiliation: Department of Ophthalmology, Pediatric Unit, University of Salerno, Salerno, Italy. magli@unina.it.
authors.forename: Adriano
authors.initials: A
authors.lastname: Magli
authors.forename: Roberta
authors.initials: R
authors.lastname: Carelli
authors.forename: Francesco
authors.initials: F
authors.lastname: Matarazzo
authors.forename: Dario
authors.initials: D
authors.lastname: Bruzzese
mesh_terms: D004948:Esotropia / Q000503:physiopathology* / Q000601:surgery; D005133:Eye Movements; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009801:Oculomotor Muscles / Q000503:physiopathology / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D011184:Postoperative Period; D012189:Retrospective Studies; D016896:Treatment Outcome; D015348:Vision, Binocular / Q000502:physiology*