April 17, 2014
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Three-muscle surgery markedly reduces deviation in large-angle infantile esotropia

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Three-muscle surgery yielded good short- and medium-term outcomes in patients with large-angle infantile esotropia, according to a study.

The retrospective study included 18 patients with large-angle infantile esotropia who underwent bilateral medial rectus muscle recession and one lateral muscle resection. Median patient age was 22 months.

Patients had onset of esotropia earlier than 6 months of age, 5/10 or better visual acuity or ability to fixate in each eye, no previous ocular muscle surgery, no neurological abnormalities or developmental delay, no organic ocular disease and preoperative esotropia of at least 55 ∆D at distance with spectacles.

Investigators assessed preoperative and postoperative deviation, overcorrection, undercorrection, need for subsequent horizontal surgery and length of follow-up. Median follow-up was 32 months.

Orthotropia to within 10 ∆D or less was achieved in 14 patients (78%).

Mean deviation decreased significantly, from 68.8 ∆D preoperatively to a median of 1 ∆D (P < .005).

Four patients had marked residual esotropia greater than 15 ∆D, requiring further surgery. No significant overcorrection greater than 10 ∆D was reported.

Disclosure: The authors have no relevant financial disclosures.