title: [Three horizontal muscle surgery for infantile esotropia and decompensated microtropia].
abstract: BACKGROUND
  Surgical management of large-angle infantile esotropia and decompensated microtropia has been controversially debated. There seems to be a relative bias against surgery on more than two horizontal muscles to avoid overcorrections. In our study we report on the sensory and motor outcomes after three horizontal muscle surgery. Furthermore we aim to suggest a table to guide surgery amounts.
  
  
  METHODS
  This study was a retrospective interventional cohort of 27 patients (16 female, 11 male; mean age 7.9 [years], ranging from 1 to 27 [years]) with infantile esotropia and decompensated microtropia who underwent three horizontal muscle surgery (bilateral medial rectus muscle recession and lateral rectus muscle plication) between 2005 and 2013.
  
  
  RESULTS
  Preoperative deviation in primary position measured 30.2 [°] (mean; range 21.9 to 48.0). Postoperatively esotropia was significantly reduced to 2.6 [°] (mean; range -16.7 to 16.7). After six months deviation measured 5.5 [°] (mean, range -14.1 to 21.9). An effect of 1.63°/mm was calculated for the combined three muscle surgery.
  
  
  CONCLUSIONS
  For the correction of large-angle infantile esotropia and decompensated microtropia three horizontal muscle surgery is associated with a high success rate. Only a very low rate of consecutive exotropia does occur.
authors.affiliation: Cantonal Hospital of St. Gallen, Department of Ophthalmology, St. Gallen, Switzerland (Chair: PD Dr. Christophe Valmaggia).
authors.forename: V
authors.initials: V
authors.lastname: Sturm
authors.affiliation: Cantonal Hospital of Aarau, Department of Ophthalmology, Aarau, Switzerland (Chair: Prof. Hanspeter E. Killer).
authors.forename: M N
authors.initials: MN
authors.lastname: Menke
authors.affiliation: University Hospital Zurich, Department of Ophthalmology, Zurich, Switzerland (Chair: Prof. Klara Landau).
authors.forename: G P
authors.initials: GP
authors.lastname: Jaggi
authors.affiliation: Cantonal Hospital of St. Gallen, Department of Ophthalmology, St. Gallen, Switzerland (Chair: PD Dr. Christophe Valmaggia).
authors.forename: P
authors.initials: P
authors.lastname: Wandernoth
authors.affiliation: Cantonal Hospital of St. Gallen, Department of Ophthalmology, St. Gallen, Switzerland (Chair: PD Dr. Christophe Valmaggia).
authors.forename: A
authors.initials: A
authors.lastname: Kunz
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004948:Esotropia / Q000191:economics* / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D009801:Oculomotor Muscles / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult