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

Camuglia, Jayne E; Walsh, Meagan; Gole, Glen A.

doi:10.1038/eye.2011.185

Cited by 18 publications

(17 citation statements)

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“…Our results agree with other authors [27,28] suggesting this approach in large angle esotropia, for the low rate of either residual esotropia or consecutive exotropia and the good long-term success rate.…”

Section: Discussionsupporting

confidence: 93%

Essential infantile esotropia: postoperative motor outcomes and inferential analysis of strabismus surgery

et al. 2014

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BackgroundThe aim of this retrospective study is a long-term evaluation of postoperative motor outcomes and the inferential analysis of strabismus surgery in infant eyes with essential infantile esotropia.Methods576 patients were compatible with the criteria: confirmed EIE diagnosis, angle ≥ 30 pD, absence of associated ocular anomalies, onset by 6 months of age, absence of hyperopia > 3 Diopters, operation before age 4. Preoperative deviation classes (30–40 pD, 41–59 pD, ≥ 60 pD) were established, different types of surgery were performed. Follow-up was conducted for 5 years after surgery. Longitudinal data were analyzed using general linear mixed models stratified according to the class of pre-operative deviation. A random intercept and a random slope with time (in months) was assumed with an unstructured within subject correlation structure for repeated measurements.ResultsIn patients with preoperative angle ≤ 40 pD, a significant interaction effect for intervention by time (F5,155.9 = 3.56, p = 0.004) and a significant intervention effect (F5,226.1 = 6.41, p < 0.001) on residual deviation were observed; only the intervention 5 showed a residual deviation inside the limits of a partial success. In Class 41-59, a significant interaction effect for intervention by time (F4,166.7 = 5.16, p = 0.001), intervention (F4,178.1 = 2.48, p = 0.046) and time (F1,174.6 = 9.99, p = 0.002) on residual deviation were observed; intervention 7 had the highest degree of stability showing an outcome within the range of a partial success. In Class ≥ 60 pD no significant effect for intervention (F4,213.9 = 0.74, p = 0.567), time (F1,169.5 = 0.33, p = 0.569) or intervention by time (F4,160.9 = 1.08, p = 0.368) on residual deviation was observed; intervention 3,6 and 7 resulted in a residual deviation within the range of a partial success.ConclusionsWe suggest, where possible, a two-horizontal muscles approach in small angle EIE, while a multiple muscles surgery in large angle EIE.

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Section: Discussionsupporting

confidence: 93%

Essential infantile esotropia: postoperative motor outcomes and inferential analysis of strabismus surgery

et al. 2014

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“…Techniques reported include augmented medial rectus recession to exceed the traditional 5 mm maximum recession, 5,31,32 simultaneous botulinum toxin A injection 33 and three-muscle surgery including bilateral medial rectus muscle recession and one lateral rectus muscle resection surgery. 3,34 After a long-term evaluation of post-operative motor outcomes in infantile esotropia, Maglia et al suggested a two-horizontal muscle approach in small-angle esotropias and a multiple-muscle surgery in large-angle esotropias. 35 Since many of our patients had large-angle esotropia, three-muscle surgery was frequently done.…”

Section: Discussionmentioning

confidence: 99%

<p>Outcome of Esotropia Surgery in 2 Tertiary Hospitals in Cameroon</p>

Dohvoma

Mvogo

Ndongo

et al. 2020

OPTH

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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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“…We believe that synoptophore measurements may be more standardized, minimizing potential errors inherent in the use of prisms or Krimsky tests for large-angle strabismus in this age group. 10,[18][19][20] It has been suggested that the synoptophore may overestimate esotropic deviations owing to presumed induced proximal convergence. It could be hypothesized that this approach might have resulted in the overestimation of undercorrections.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 Popular surgical options include large bilateral medial rectus muscle recessions [3][4][5] and selective surgery on 3 or even 4 extraocular muscles. [6][7][8][9][10] Alternative approaches include large unilateral medial rectus muscle recession and lateral rectus muscle resection or adding conjunctival recession, medial pulley fixation, or botulinum toxin treatment to the medial rectus muscle recession. [11][12][13] Many strabismologists would opt for large bilateral medial rectus muscle recessions because this is a simple symmetrical approach, involves a shorter operating time, and leaves the lateral rectus muscles untouched for subsequent surgery, if needed.…”

mentioning

confidence: 99%

“…[11][12][13] Many strabismologists would opt for large bilateral medial rectus muscle recessions because this is a simple symmetrical approach, involves a shorter operating time, and leaves the lateral rectus muscles untouched for subsequent surgery, if needed. 1,[3][4][5] Others prefer to add 1 or even 2 lateral rectus muscle resections [7][8][9][10] to minimize the rate of undercorrections, which has variably been reported between 13% and 60% for large bilateral medial rectus muscle recessions. 5,14,15 Another attribute of interest to the family and to health care providers is the long-term stability of outcome.…”

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confidence: 99%

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Three Horizontal Muscle Surgery for Large-Angle Infantile or Presumed Infantile Esotropia

et al. 2013

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IMPORTANCE Bilateral medial rectus muscle recession and one lateral rectus muscle resection surgery for the correction of large-angle infantile esotropia may be associated with a favorable long-term motor outcome. A consecutive exotropic drift was encountered more commonly than a recurrent esotropic drift in the long run, especially in the smaller (50-69 prism diopters [Δ]) range of preoperative esodeviation. OBJECTIVE To outline the short-and long-term motor outcomes of graded bilateral medial rectus muscle recession and one lateral rectus muscle resection for the correction of large-angle esotropia (Ն50Δ). DESIGN Retrospective analysis. SETTING Strabismus service, tertiary care university referral center. PARTICIPANTS A total of 194 consecutive patients with infantile or presumed infantile esotropia. EXPOSURE All patients underwent bilateral medial rectus recession and a lateral rectus resection in the nondominant eye by the same surgeon. MAIN OUTCOMES AND MEASURES Short-term (8 weeks) and long-term rates of postoperative successful alignment (±10Δ), undercorrection, and overcorrection. RESULTS The median age of patients at surgery was 2.7 years (range, 20 months-36 years). The median follow-up time was 4.5 years (range, 6 weeks-25 years). The mean preoperative deviation was 68.2Δ. Of the 194 patients, 121 (62.4%) were successfully aligned at the last follow-up visit or prior to reoperation, and 154 (79.4%) were successfully aligned at the 8-week postoperative evaluation. A comparison of early vs late outcomes revealed a higher rate of late overcorrections (5.15% vs 24.1%, respectively; P = .001) but the same rate of undercorrections (15.4% vs 15.1%; P = .85). The outcome of surgery was not associated with the presence of amblyopia, high hyperopia, or the total amount of millimeters of surgery but was adversely influenced by the presence of inferior oblique overaction and the magnitude of the preoperative esodeviation. Delayed consecutive exotropia was more prevalent in the 50Δ to 69Δ range of preoperative esodeviation. CONCLUSIONS AND RELEVANCE Three horizontal muscle surgery for the correction of large-angle esotropia is associated with a high success rate. Long-term follow-up indicated that an exotropic drift may be expected 3 times more often than an esotropic drift.

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

Cited by 18 publications

References 20 publications

Essential infantile esotropia: postoperative motor outcomes and inferential analysis of strabismus surgery

Essential infantile esotropia: postoperative motor outcomes and inferential analysis of strabismus surgery

<p>Outcome of Esotropia Surgery in 2 Tertiary Hospitals in Cameroon</p>

Three Horizontal Muscle Surgery for Large-Angle Infantile or Presumed Infantile Esotropia

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