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Three horizontal muscle surgery for large-angle infantile esotropia: validation of a table of amounts of surgery

Lookup NU author(s): Dr Meagan Walsh

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Abstract

Purpose To validate a table of amounts of three horizontal muscle surgery in patients with large-angle infantile esotropia (>= 60 prism dioptres, PD).Methods A prospective interventional case series reporting the postoperative alignment of 51 patients (27 male, 24 female) over a 15-year period was conducted. Surgery amounts were according to a published table developed on a previous patient cohort (n = 49), using bilateral medial rectus recession with graded unilateral lateral rectus resection. Kaplan-Meier life-table survival curves were formulated for success to orthotropia (+/- 10 PD) after one and subsequent horizontal muscle surgeries for up to 8 years follow-up.Results The median preoperative deviation was 65 PD (range 60-80 PD) and median age at surgery was 11.8 months (range 5.1 months-3.6 years). Surgical success to orthotropia (+/- 10 PD) after one surgery was 100% at 2 months, 95.7% at 6 months, 91.3% at 12 months, 77.8% at 4 years, and 73.6% at 8 years. Postoperative failure requiring further horizontal surgery occurred in 17.6% (residual esotropia 4, consecutive exotropia 5).Conclusions Our second cohort has reproduced the success rate of the previous cohort (77.8% vs 77.1% at 4 years). If the published table of surgical amounts is used, three horizontal muscle surgery in large-angle infantile esotropia (>= 60 PD) appears to have a good long-term success rate, and does not lead to the high rates of either residual esotropia or consecutive exotropia reported by others in the literature. Eye (2011) 25, 1435-1441; doi:10.1038/eye.2011.185; published online 5 August 2011

Publication metadata

Author(s): Camuglia JE, Walsh MJ, Gole GA

Publication type: Article

Publication status: Published

Journal: Eye

Year: 2011

Volume: 25

Issue: 11

Pages: 1435-1441

Print publication date: 05/08/2011

ISSN (print): 0950-222X

ISSN (electronic): 1476-5454

Publisher: Nature Publishing Group

URL: http://dx.doi.org/10.1038/eye.2011.185

DOI: 10.1038/eye.2011.185

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