Singh Anirudh, Parihar J K S, Mishra S K, Maggon R, Badhani Anurag
Senior Adviser (Ophthalmology, Paed Ophthal & Squint), Army Hospital (R&R), Delhi Cantt, India.
Addl DGAFMS (MR H & Trg), O/o DGAFMS, Ministry of Defence "M" Block, New Delhi 110001, India.
Med J Armed Forces India. 2017 Apr;73(2):129-133. doi: 10.1016/j.mjafi.2016.11.006. Epub 2017 Jan 13.
Infantile esotropia is a convergent strabismus presenting before 6 months of age and is the most common strabismus disorder presenting in the ophthalmology OPD. The dilemma of whether to go for early surgery and how early has been a matter of research for the last 50 years. We describe our results of surgery in infantile esotropia at variable age groups, as well as with different reoperation rates and compare with the results in western literature.
A prospective study was carried out through a review of 113 cases operated for infantile esotropia between February 2013 and August 2014. The variables studied were: age at surgery, type of fixation, refractive error, associated nystagmus, inferior oblique overaction or dissociated vertical deviation (DVD), type of surgery performed and pre- and postoperative deviation angles.
There were 67 male and 46 female cases of infantile esotropia. The age group of patients varied from 6 months to 12 years. Latent nystagmus was seen in 22 cases, inferior oblique overaction in 49 cases and DVD (mild) in 14 cases. Bimedial rectus recession was done in 78 cases and recession-resection in non-dominant eye in remaining 35 cases. The postoperative residual deviation was <10 PD in 102 cases, between 10 and 16 PD in 5 cases and more than 16 PD in 6 cases. Only 6 cases (5.3%) required reoperation for correction of residual deviation.
The authors recommend surgery before 12 months in all cases of infantile esotropia. The reoperation rates in the current study were considerably low.
婴儿型内斜视是一种在6个月龄前出现的会聚性斜视，是眼科门诊中最常见的斜视疾病。在过去50年里，是否进行早期手术以及多早进行一直是研究的难题。我们描述了不同年龄组婴儿型内斜视的手术结果，以及不同的再次手术率，并与西方文献中的结果进行比较。
通过回顾2013年2月至2014年8月间113例接受婴儿型内斜视手术的病例进行前瞻性研究。研究的变量包括：手术年龄、注视类型、屈光不正、相关的眼球震颤、下斜肌亢进或分离性垂直偏斜（DVD）、所施行的手术类型以及术前和术后的偏斜角度。
婴儿型内斜视病例中男性67例，女性46例。患者年龄组从6个月至12岁不等。22例出现潜在性眼球震颤，49例出现下斜肌亢进，14例出现DVD（轻度）。78例行双眼内直肌后徙术，其余35例行非主眼后徙-切除术。术后残留偏斜<10三棱镜度（PD）的有102例，10至16 PD的有5例，超过16 PD的有6例。仅6例（5.3%）因残留偏斜矫正需要再次手术。
作者建议对所有婴儿型内斜视病例在12个月前进行手术。本研究中的再次手术率相当低。
