Long term outcome of treated congenital/infantile esotropia: does early surgical binocular alignment restoring (subnormal) binocular vision guarantee stability? 1998

J Prieto-Diaz, and I Prieto-Diaz
Ophthalmology Institute, La Plata, Argentina.jprietodtlink.com

OBJECTIVE To answer this important outcome question. METHODS Retrospective review of a series of 60 qualified cases of congenital/infantile esotropia surgically binocularly "aligned" (= orthotropia +/- 8 PD) before 30 months of age and showing at one postoperative examination date at least some degree of (subnormal) binocular vision. Every patient was monitored over a very long postoperative followup period (mean 14.7 +/- 3.7 years). RESULTS Early binocular alignment with some binocular cooperation does not guarantee a stable outcome. However, even though the final percentage of patients losing "alignment" is similar to that observed in other non-qualified series of "aligned" congenital/infantile esotropias, the loss of "alignment" takes place at a much later age, if some binocular cooperation was present at some time in the past. CONCLUSIONS For congenital/infantile esotropia, achieving, at an early age, binocular "alignment" with some degree of binocular vision delays the loss of "alignment" and seems to reduce the chance of developing oblique muscle overactions.

UI MeSH Term Description Entries
D009801 Oculomotor Muscles The muscles that move the eye. Included in this group are the medial rectus, lateral rectus, superior rectus, inferior rectus, inferior oblique, superior oblique, musculus orbitalis, and levator palpebrae superioris. Extraocular Muscles,Extraocular Rectus Muscles,Inferior Oblique Extraocular Muscle,Inferior Oblique Muscles,Levator Palpebrae Superioris,Musculus Orbitalis,Oblique Extraocular Muscles,Oblique Muscle, Inferior,Oblique Muscle, Superior,Oblique Muscles, Extraocular,Rectus Muscles, Extraocular,Superior Oblique Extraocular Muscle,Superior Oblique Muscle,Extraocular Muscle,Extraocular Muscle, Oblique,Extraocular Muscles, Oblique,Extraocular Oblique Muscle,Extraocular Oblique Muscles,Extraocular Rectus Muscle,Inferior Oblique Muscle,Muscle, Oculomotor,Muscles, Oculomotor,Oblique Extraocular Muscle,Oblique Muscle, Extraocular,Oblique Muscles, Inferior,Oblique Muscles, Superior,Oculomotor Muscle,Rectus Muscle, Extraocular,Superior Oblique Muscles
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D012008 Recurrence The return of a sign, symptom, or disease after a remission. Recrudescence,Relapse,Recrudescences,Recurrences,Relapses
D012029 Refraction, Ocular Refraction of LIGHT effected by the media of the EYE. Ocular Refraction,Ocular Refractions,Refractions, Ocular
D004948 Esotropia A form of ocular misalignment characterized by an excessive convergence of the visual axes, resulting in a "cross-eye" appearance. An example of this condition occurs when paralysis of the lateral rectus muscle causes an abnormal inward deviation of one eye on attempted gaze. Esophoria,Strabismus, Convergent,Strabismus, Internal,Convergent Strabismus,Cross-Eye,Esodeviation,Intermittent Esotropia,Internal Strabismus,Monocular Esotropia,Primary Esotropia,Secondary Esotropia,Cross Eye,Cross-Eyes,Esodeviations,Esophorias,Esotropia, Intermittent,Esotropia, Monocular,Esotropia, Primary,Esotropia, Secondary,Esotropias,Intermittent Esotropias,Monocular Esotropias,Primary Esotropias,Secondary Esotropias
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000550 Amblyopia A nonspecific term referring to impaired vision. Major subcategories include stimulus deprivation-induced amblyopia and toxic amblyopia. Stimulus deprivation-induced amblyopia is a developmental disorder of the visual cortex. A discrepancy between visual information received by the visual cortex from each eye results in abnormal cortical development. STRABISMUS and REFRACTIVE ERRORS may cause this condition. Toxic amblyopia is a disorder of the OPTIC NERVE which is associated with ALCOHOLISM, tobacco SMOKING, and other toxins and as an adverse effect of the use of some medications. Anisometropic Amblyopia,Lazy Eye,Amblyopia, Developmental,Amblyopia, Stimulus Deprivation-Induced,Amblyopia, Suppression,Stimulus Deprivation-Induced Amblyopia,Amblyopia, Anisometropic,Amblyopia, Stimulus Deprivation Induced,Amblyopias,Amblyopias, Anisometropic,Amblyopias, Developmental,Amblyopias, Stimulus Deprivation-Induced,Amblyopias, Suppression,Anisometropic Amblyopias,Deprivation-Induced Amblyopia, Stimulus,Deprivation-Induced Amblyopias, Stimulus,Developmental Amblyopia,Developmental Amblyopias,Eye, Lazy,Eyes, Lazy,Lazy Eyes,Stimulus Deprivation Induced Amblyopia,Stimulus Deprivation-Induced Amblyopias,Suppression Amblyopia,Suppression Amblyopias
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective

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