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Negishi T, Nakao S. Surgery for Esotropia in a Case of Nanophthalmos. Cureus 2024; 16:e63728. [PMID: 39099983 PMCID: PMC11295114 DOI: 10.7759/cureus.63728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2024] [Indexed: 08/06/2024] Open
Abstract
Nanophthalmos, characterized by an abnormally small ocular globe, presents significant challenges in the management of strabismus due to its unique anatomical constraints. This detailed case report highlights the intricacies and outcomes of strabismus surgery in a patient with nanophthalmos, providing valuable insights into the surgical considerations and adaptations required for this rare condition. The subject of this case, a young girl diagnosed with esotropia and high hyperopia, underwent unilateral medial rectus muscle recession in an attempt to correct her esotropia. Despite the careful surgical approach and postoperative management, a two-year follow-up revealed a limited response to the intervention, with improvements in visual acuity but continued presence of esotropia and lack of stereopsis development. This case sheds light on several key considerations in the surgical treatment of strabismus in nanophthalmos patients, including the potential for reduced surgical effectiveness due to the small globe size, the importance of accurate preoperative assessment, and the challenges in predicting surgical outcomes. Additionally, it discusses the implications of these findings for future surgical planning, the potential need for revision surgeries, and the broader research context, emphasizing the necessity for a deeper understanding of the biomechanical and anatomical particularities of nanophthalmos in the context of strabismus surgery. The report concludes with recommendations for improving surgical strategies and patient outcomes, advocating for more comprehensive studies and a tailored approach to treating strabismus in individuals with nanophthalmos.
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Affiliation(s)
- Takashi Negishi
- Department of Ophthalmology, Juntendo University Faculty of Medicine, Tokyo, JPN
| | - Shintaro Nakao
- Department of Ophthalmology, Juntendo University Faculty of Medicine, Tokyo, JPN
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Mutaf C, Ocak B, Inal A, Hazar L, Gokyigit B. Treatment of Infantile Esotropia - Comparison Between Botulinum Toxin A and Bilateral Medial Rectus Recession. BEYOGLU EYE JOURNAL 2024; 9:20-25. [PMID: 38504960 PMCID: PMC10944856 DOI: 10.14744/bej.2024.90958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/22/2024] [Accepted: 02/05/2024] [Indexed: 03/21/2024]
Abstract
Objectives The objective of the study is to evaluate the examination findings, treatment methods, and follow-up results of children diagnosed with infantile esotropia (IE) and to compare botulinum toxin A (BTA) and bilateral medial rectus (MR) recession surgery. Methods We retrospectively reviewed the medical records of patients who were diagnosed with IE. The age of the patient and the angle of deviation were taken into account to determine the treatment. Patients who underwent bilateral MR recession surgery and BTA injection were analyzed and the BTA and surgical groups were compared. Successful correction was defined as orthotropia and a deviation of up to 10 prism diopters (PD) after one surgical procedure or 1-3 botulinum injections. Results Two hundred and forty-six patients with esotropia were included in the study. Twelve were followed up with refractive correction only. BTA injection was administered to 110 patients, while 124 patients underwent bilateral MR recession. The age of the patients ranged from three to 39 months. Patients were followed for at least 6 months, with a mean follow-up of 24.3 months in the BTA group and 21.7 months in the surgical group (p=0.23). The mean pre-treatment angle deviation was 38.9 PD in the BTA group and 40.1 PD in the surgical group (p=0.62). The success rate for patients with more than 30 PD of deviation was 72% in the surgical group compared to 36% in the BTA group (p<0.001). No statistically significant difference in success rate was observed in patients with deviations <30 PD (surgery 62%, BTA 55%, p=0.26). Conclusion Surgical treatment of IE was more successful than BTA injection in patients with large angle deviations (>30 PD). BTA injection can be considered as an alternative to surgery in cases of small to moderate angle deviations (<30 PD).
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Affiliation(s)
- Cagri Mutaf
- Department of Ophthalmology, Harran University Faculty of Medicine, Sanlıurfa, Turkiye
| | - Bulut Ocak
- Department of Ophthalmology, Dunya Eye Hospital, Istanbul, Turkiye
| | - Asli Inal
- Department of Ophthalmology, Beyoglu Eye Training and Research Hospital, Istanbul, Turkiye
| | - Leyla Hazar
- Department of Ophthalmology, Dicle University Faculty of Medicine, Diyarbakir, Turkiye
| | - Birsen Gokyigit
- Department of Ophthalmology, Yeni Yuzyil University, Istanbul, Turkiye
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Dohvoma VA, Ebana Mvogo SR, Ndongo JA, Mvilongo CT, Ebana Mvogo C. Outcome of Esotropia Surgery in 2 Tertiary Hospitals in Cameroon. Clin Ophthalmol 2020; 14:449-454. [PMID: 32103891 PMCID: PMC7025669 DOI: 10.2147/opth.s241861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 01/21/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate the ocular alignment following esotropia surgery in our setting. Patients and Methods We conducted a cross sectional descriptive study which spanned 19 years, from October 1999 to September 2018 at the Douala General Hospital and the Yaoundé Central Hospital. Complete medical records of patients who underwent surgery for esotropia during the study period were included. Data collected included age at diagnosis, sex, age of onset of esotropia, age at surgery, refractive error, type of surgery performed, pre and post-operative angle of deviation. The outcome was considered good when the postoperative angle was ≤10 prism diopters (PD). Results Four hundred and ninety patients with primary esotropia were seen during the study period. Only 155 returned for follow-up after wearing the full cycloplegic correction for a minimum period of 3 months. Accommodative esotropia was found in 32 cases (20.6%). Among the 123 cases requiring surgery, 63 cases underwent surgery (51.2%). Fifty-nine complete records were included (59.3% females and 40.7% males). The mean age at the time of diagnosis was 6.5 ± 6.1 years and the mean age at the time of surgery was 8.7 ± 6.1 years. The mean preoperative angle at distance was 42.8 ±10.8 PD. The outcome was good in 91.5% of cases. No factor influenced the outcome of surgery. Conclusion The outcome of esotropia surgery was good in this study. This could serve to increase patient motivation to accept surgery in our setting.
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Affiliation(s)
- Viola Andin Dohvoma
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.,Yaoundé Central Hospital, Yaoundé, Cameroon
| | | | - Jean Audrey Ndongo
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | | | - Côme Ebana Mvogo
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.,Yaoundé Central Hospital, Yaoundé, Cameroon
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Sulayem LM, Bin-Khathlan AA. Outcomes of esotropia surgery in Saudi Arabia: An audit from a single center. Saudi J Ophthalmol 2018; 32:280-285. [PMID: 30581297 PMCID: PMC6300749 DOI: 10.1016/j.sjopt.2018.07.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 07/31/2018] [Indexed: 02/05/2023] Open
Abstract
Purpose To monitor the outcomes of surgical correction of esotropia in order to improve preoperative counselling for patients and their families. Methods A retrospective review audit of the medical charts at King Fahad Medical City. All patients treated surgically to correct esotropia, from January 2007 to December 2013. All operated cases were included regardless of age and esotropia etiology. The study used a goal-determined metric to assess the outcomes of strabismus surgery > 6 months post-operatively, and on last follow-up. The risk factors for poor surgical outcomes were identified using a Pareto chart. Results A total of 99 cases with sufficient documentation to determine the surgical goal were included in the analysis. The goal was to improve eye contact (cosmetic correction) in 77.8% cases, to establish binocularity in 15.2% cases, to resolve diplopia for 4% cases, and to improve anomalous head posture for 3%. The overall outcome was excellent for 70.7% at the first follow-up and for 57.6% at the final visit. Simultaneous vertical muscle surgery and/or superior oblique muscle palsy were risk factors for poor outcome (odds ratio 3.15, 95% CI 1.11–8.99). Conclusions Excellent outcome of esotropia surgery in this study is comparable to outcomes reported internationally using the goal determined metrics. Quality improvement processes like the Pareto chart are simple to use and helpful for determining the risk factors associated with poor surgical outcomes after esotropia correction from different etiology.
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Affiliation(s)
- Lujain M Sulayem
- King Fahad Medical City, P.O. Box 1141, Al-Muruj, Riyadh 11431, Saudi Arabia
| | - Afaf A Bin-Khathlan
- King Fahad Medical City, P.O. Box 3805, Al-Masif, Riyadh 12468, Saudi Arabia
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Kim E, Choi DG. Comparison of Surgical Outcomes Between Bilateral Medial Rectus Recession and Unilateral Recess-Resect for Infantile Esotropia. Ophthalmic Epidemiol 2018; 26:102-108. [PMID: 30252566 DOI: 10.1080/09286586.2018.1523440] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PURPOSE To compare surgical outcomes between bilateral medial rectus recession (BMR) and unilateral medial rectus recession-lateral rectus resection (RR) for infantile esotropia. METHODS In this retrospective study, BMR was performed on 57 patients (BMR group) and RR on 23 (RR group) for treatment of infantile esotropia with the postoperative follow-up period of 6 months or more. The main outcome measures were angle of esodeviation, rate of surgical success, rate of reoperation, rate of postoperative development of DVD, and postoperative sensory status. Surgical success was defined as esotropia or exotropia of 10 PD or less. RESULTS The mean preoperative esodeviation at near was 44.1 prism diopters (PD) in BMR, and 40.2 PD in RR (p = 0.161). There was no statistically significant difference in angles of deviation between BMR and RR from postoperative day 1 to final follow-up, respectively (p > 0.05). Whereas until postoperative month 6 the surgical success rate did not significantly differ, from postoperative year 1 to final follow-up it was significantly higher in BMR than in RR (p < 0.05). The final success rates were 80.70% and 56.52% for BMR and RR, respectively (p = 0.047). The reoperation rate, correspondingly, was significantly lower for BMR (17.54%) than for RR (60.78%) (p = 0.000). CONCLUSION There was no significant difference in the mean postoperative angle of deviation between BMR and RR for infantile esotropia. However, the final success rate was higher (p = 0.047) and the reoperation rate was lower for BMR than for RR (p = 0.000).
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Affiliation(s)
- Eunbi Kim
- a Department of Ophthalmology , Hallym University College of Medicine , Seoul , South Korea
| | - Dong Gyu Choi
- a Department of Ophthalmology , Hallym University College of Medicine , Seoul , South Korea
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Rajavi Z, Sabbaghi H, Torkian P, Behradfar N, Yaseri M, Feizi M, Faghihi M, Sheibani K. The relationship between abduction deficit and reoperation among patients with infantile esotropia. Int J Ophthalmol 2018; 11:478-483. [PMID: 29600183 DOI: 10.18240/ijo.2018.03.19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 12/25/2017] [Indexed: 11/23/2022] Open
Abstract
AIM To determine the relationship between abduction deficit and reoperation among patients with infantile esotropia (IET). METHODS The records of 216 patients (432 eyes) with IET who underwent surgery, from 2010 to 2015 were studied. Patients with IET whose deviation appeared before 6mo of age and had stable preoperative deviation in two examinations with at least 2wk apart and a minimum 3mo postoperative follow up were included. Cases with early onset accommodative esotropia, congenital cataract, retinopathy of prematurity (ROP), manifest nystagmus, fundus lesions, neurologic and ophthalmic anomalies, 6th nerve palsy and Duane's syndrome were excluded. Preoperative abduction deficit was considered from -1 to -3 grading scale. Three months after surgery, children were classified into no-need reoperation [deviation≤15 prism diopters (PD)], and need-reoperation groups (deviation>15 PD). RESULTS In this retrospective study, 117 female and 99 male patients with the mean surgical age of 4.7±6.4y were included. Reoperation rate was 33.3% and 16.0% in IET patients with and without abduction deficit, respectively in patients who had a history of late surgery. Abduction deficit increased the odds of reoperation by 82% [OR=1.82, 95% confidence interval (CI) =1.05 to 3.19, P=0.003] in patients who had a history of late surgery (>2 years old, P=0.021). Abduction deficit was improved significantly after operation (P<0.001). CONCLUSION Based on our results, abduction deficit can be considered as a risk factor of reoperation in IET patients who are operated at the age of more than 2y.
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Affiliation(s)
- Zhale Rajavi
- Ophthalmic Epidemiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran 1666673111, Iran.,Department of Ophthalmology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran 1985717443, Iran
| | - Hamideh Sabbaghi
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran 1666673111, Iran.,Department of Optometry, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran 1616913111, Iran
| | - Pooya Torkian
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran 1985717443, Iran
| | - Narges Behradfar
- Department of Optometry, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran 1616913111, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran 1417613151, Iran
| | - Mohadeseh Feizi
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran 1666673111, Iran.,Torfeh Eye Hospital, Shahid Beheshti University of Medical Sciences, Tehran 1149847514, Iran
| | - Mohammad Faghihi
- Torfeh Eye Hospital, Shahid Beheshti University of Medical Sciences, Tehran 1149847514, Iran
| | - Kourosh Sheibani
- Basir Eye Health Research Center, Basir Eye Clinic, Tehran 1418643113, Iran
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Magli A, Carelli R, Chiariello Vecchio E, Esposito F, Rombetto L, Esposito Veneruso P. Essential infantile esotropia with inferior oblique hyperfunction: long term follow-up of 6 muscles approach. Int J Ophthalmol 2016; 9:1802-1807. [PMID: 28003983 DOI: 10.18240/ijo.2016.12.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Accepted: 06/12/2016] [Indexed: 11/23/2022] Open
Abstract
AIM To evaluate long term follow-up (10y) of 6 muscle surgical approach in essential infantile esotropia (EIE). METHODS A 6 muscle approach to EIE was retrospectively evaluated in patients with inferior oblique (IO) hyperfunction and lateral rectus (LR) pseudoparalysis, who underwent surgery at different ages. Different clinical characters were analyzed pre- and postoperatively, in patients who underwent a 6 muscles approach ≤4 years of age. All patients underwent a multiple muscles approach: bilateral medial recti (MR) recession (4-5 mm), bilateral LR resection (lower than 7 mm) and bilateral IO recession and anteroposition. Of 108 children with preoperative angle ≥+30 prism diopters (PD) and IO hyperfunction were selected from larger cohort of patients (n=213, 103 females and 110 males) after excluding patients with: angle variability, who underwent reoperation and with incomplete follow up. Preoperative assessment and complete orthoptic examination were performed. Follow-up was performed 3mo, 2, 5 and 10y after surgery. Statistical analysis was performes using SAS statistical software package (version 9.1, SAS Institute Inc., Cary, NC, USA). RESULTS Ten years follow up data analysis showed the following percentage of orthotropic patients: (0 PD): 3mo, 22.2%; 2y, 16.7%; 5y, 25.0% and 10y, 27.8%. A slight, significant (P<0.01), increase of 2y follow up residual deviation was found when compared to 3mo one. Stationary surgical results is reported during time, with a trend of mean residual deviation reduction (P=0.04). CONCLUSION Our results confirm the reliability of multiple muscles surgical approach in the treatment of patients affected by EIE with OI hyperfunction.
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Affiliation(s)
- Adriano Magli
- Department of Pediatric Ophthalmology, University of Salerno, Baronissi (SA) 84081, Italy
| | - Roberta Carelli
- Department of Pediatric Ophthalmology, University of Salerno, Baronissi (SA) 84081, Italy
| | | | | | - Luca Rombetto
- Department of Ophthalmology, University Federico II, Naples 80131, Italy
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Magli A, Rombetto L, Matarazzo F, Carelli R. Infantile esotropia: risk factors associated with reoperation. Clin Ophthalmol 2016; 10:2079-2083. [PMID: 27799735 PMCID: PMC5077265 DOI: 10.2147/opth.s116103] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The aim of this study was to identify clinical and demographic factors associated with misalignment after first surgery performed on children affected by infantile esotropia to evaluate the reoperation rate. A retrospective study was carried out, analyzing data from 525 children who underwent bilateral medial recti recession, bilateral lateral recti resection, and inferior oblique recession and anteroposition by the same surgeon (AM). Postoperative evaluation included assessment of motor alignment at approximately 3 months, 6 months, 1 year, and 5 years. Statistical analysis was performed with a logistical regression model in which the dependent variable was the presence/absence of reoperation. We found that late surgery (after 3 years of age) and a family history of strabismus are associated with a higher risk of reoperation, while some clinical factors, including some classically associated with worst motor outcome as preoperative angle, dissociated vertical deviation, and amblyopia, did not influence the incidence of reoperation in infantile esotropia. Male patients and patients with hyperopia in preoperative examinations have a significantly decreased reoperation rate.
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Affiliation(s)
- Adriano Magli
- Department of Ophthalmology, Orthoptics and Pediatric Ophthalmology, University of Salerno, Salerno
| | - Luca Rombetto
- Department of Ophthalmology, Federico II University, Naples, Italy
| | | | - Roberta Carelli
- Department of Ophthalmology, Orthoptics and Pediatric Ophthalmology, University of Salerno, Salerno
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Kiziltunc PB, Atilla H, Çalış F, Alay C. Comparison of Surgical Success for Infantile Esotropia and Strabismus Associated with Neurological Impairment. Strabismus 2016; 24:97-100. [PMID: 27532638 DOI: 10.1080/09273972.2016.1210173] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Surgery for strabismus associated with neurological impairment is assumed to have unsatisfactory results in comparison with other strabismus cases. The aim of this study is to compare the surgical success rates of infantile esotropia (IE) and strabismus associated with neurological impairment. METHODS The records of 103 patients that received operations for IE and strabismus associated with neurological impairment between January 1994 and May 2014 were reviewed retrospectively. The angles of deviation and surgical success rates were evaluated at preoperative, 1-month postoperative, and 24-month postoperative visits. RESULTS Forty-five patients received operations for strabismus associated with neurological impairment (25 patients with esotropia and 20 patients with exotropia) and 58 patients for IE. Mean preoperative angles of deviation in cases with neurological impairment were 42 prism diopters (PD) for esotropia, 44.7 PD for exotropia, and 44.4 PD for IE. One patient from each group had consecutive deviation at first visit, and at last visit, 3 patients with neurological impairment and 5 patients with IE had consecutive deviations. Surgical success rates at the end of the second year were 52% for esotropia and 50% for exotropia in patients with neurological impairment and 56.8% for IE cases. CONCLUSION This study was unable to find the differences between surgical success rates in IE and strabismus associated with neurological impairment.
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Affiliation(s)
| | - Huban Atilla
- b Ankara University , Faculty of Medicine, Department of Ophthalmology , Ankara , Turkey
| | - Feyza Çalış
- c Cihanbeyli State Hospital , Konya , Turkey
| | - Cem Alay
- d Tavsanli Doctor Mustafa Kalemli State Hospital , Kutahya , Turkey
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Magli A, Carelli R, Esposito F, Bruzzese D. Essential Infantile Esotropia: Postoperative Sensory Outcomes of Strabismus Surgery. Semin Ophthalmol 2016; 32:663-671. [PMID: 27367798 DOI: 10.3109/08820538.2016.1157614] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The optimum age for Essential Infantile Esotropia surgery is a controversial subject. Sensory status was evaluated in patients who underwent surgery at different ages in a retrospective study. The setting of the study is the ophthalmology department of a teaching hospital. METHODS Different clinical characters were analyzed pre- and postoperatively; nine different surgeries were performed. A total of 188 patients presented valid postoperative sensorial data, divided in two groups: surgery at ≤2 years (n=69) or >2 years (n=119). Sensory status was dichotomized in binocular single vision (BSV) and exclusion. Univariate differences were assessed with the chi-square test (or Fisher exact test). To identify the independent role of factors associated with the sensory status, all variables showing in univariate analyses a significant association (p<0.05) with the outcome variable were entered into a multivariate logistic regression model. All statistical tests were two-sided. RESULTS Multivariate analysis confirmed that children operated >2 years were 0.4 times less likely to obtain BSV compared with children operated at ≤2 years (AOR. 0.38, 95% C.I. 0.17-0.89, p=0.025). Patients operated on by OO MR rec.+ OO LR res. + OO IO rec.-ap. (intervention type 6) were about 11 times more likely to have BSV than those by OO rec.MR + unilateral res. LR (operation type 2); AOR.: 10.67, 95% C.I.: 1.34 - 85.29, p=0.026). Twenty-nine patients (12.1%) operated at ≤2 years of age underwent a reoperation, compared to 33 (8.6%) who underwent surgery after two years (p>0.05). CONCLUSIONS Our findings suggest to perform EIE surgery between age 1 and 2 and, when indicated, to prefer a six-muscle approach in order to achieve a better sensory function.
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Affiliation(s)
- Adriano Magli
- a University of Salerno , Pediatric Eye Department , Salerno , Italy
| | - Roberta Carelli
- a University of Salerno , Pediatric Eye Department , Salerno , Italy
| | | | - Dario Bruzzese
- c University of Naples Federico II , Department of Preventive Medical Science , Naples , Italy
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Kim YJ, Shin KH, Paik HJ. Surgical Outcomes Dependent on the Amount of Hyperopia in Infantile Esotropia. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2016. [DOI: 10.3341/jkos.2016.57.11.1752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Yu Jeong Kim
- Department of Ophthalmology, Gachon University Gil Hospital, Incheon, Korea
| | - Kwang Hoon Shin
- Department of Ophthalmology, Gachon University Gil Hospital, Incheon, Korea
| | - Hae Jung Paik
- Department of Ophthalmology, Gachon University Gil Hospital, Incheon, Korea
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Abstract
PURPOSE OF REVIEW Surgical treatment has been the accepted mode of treatment for infantile esotropia for decades. The present review of recent literature evaluates the current standing of: type of surgery performed and best timing of surgery to achieve optimal results. RECENT FINDINGS Recent studies suggest that early surgical intervention is of benefit by improving the probability of developing stereopsis. A significant advantage of the type of surgical intervention has yet to be demonstrated by the current studies. Botulinum toxin continues to be used for treatment of infantile esotropia, although it has not been shown to be a superior treatment. SUMMARY Although many theories exist, the true cause of infantile esotropia remains unknown. The literature suggests that treatment before age 2 and perhaps even earlier improves the potential for binocular vision. After significant review of literature, it is clear that surgery is the treatment of choice for infantile esotropia but no method has a clear advantage. Efforts to define the best surgical procedure and timing of surgery through prospective, randomized multicenter trials are warranted.
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