Abstract
Abstract: :
Purpose: To investigate the long–term results of early surgery for children with infantile esotropia in whom surgery was performed within 6 months after birth, and follow–up was possible for 4 years or more after surgery. Methods: In 7 children with infantile esotropia and 40 PD or more esodeviation before surgery (2 boys, 5 girls) who underwent surgery for strabismus within 6 months after birth between 1992 and 1998, and could be followed up for 4 years or more after surgery, we evaluated binocularity, alignment, visual acuity, refractive error, presence or absence and timing of additional surgery, and postoperative stability of ocular position at the final examination. For the binocularity test, Bagolini’s striated lens test and TNO randam dot stereo test were used, and Alternate prism cover test (5 m, 0.3 m) was used to measure alignment. For surgery, recession of both medial rectus muscle was performed after confirming that the preoperative esodeviation was 40 PD or more and stable by 2 or more sets of measurement. Results: Ages at surgery were 5 months in 3 children and 6 months in 4 children. Additional surgery was performed in 6 children (85.7%), and ages at additional surgery ranged from 2.4 to 5.6 years. The mean postoperative follow–up period (±SD) was 7±2 years. The mean refractive error (±SD) was 0.46±0.86 D. In all children, visual acuity was 1.0 or higher. At the final examination,near deviation ranged from –8 to 20 PD, and distant deviation ranged from –6 to 25 PD (–: exodeviation). Dissociated vertical deviation was observed in 6 children (86%), and over action of the inferior oblique muscle was noted in 3 children (43%). Binocular single vision was observed in 5 children (71%) at distant and in 7 children (100%) at near. No child showed stereopsis. Conclusions: Stereopsis could not be achieved despite early surgery, suggesting that a basic network involved in formation of stereopsis vision is not acquired but inherent.
Keywords: strabismus: treatment • esotropia and exotropia • binocular vision/stereopsis