Tunis Med. 2021;99(12):1180-1187.
Infantile esotropia is characterized by a significant deviation angle and a marked sensory perversion. Although the motor surgical results are satisfactory, the sensory results remain disappointing.
Our work aims to describe the methods of surgical management, its motor and sensory results as well as its prognostic factors.
Retrospective study of 68 cases of infantile esotropia. All patients underwent a complete ophthalmologic examination and sensorimotor assessment. They were operated on, under general anesthesia, by the same surgeon. We assessed the motor and sensory results. The prognostic factors studied were age of onset, treatment delay, amblyopia severity, strabismus deviation angle, and presence of a vertical element.
The mean minimum angle of deflection was 38.6 ± 13.2D. Inferior oblique muscle hyper action was noted in 73.5% and a dissociated vertical deviation in 5.8%. Bilateral medial rectus muscle recession was the most performed surgery (60.2% of cases). The overall success rate was 94.11%. No patient acquired stereoscopic vision. Multivariate logistic regression analysis showed that preoperative nail (p = 0.007), immediate postoperative outcome (p <0.001) and surgical dosage (p = 0.009) were associated with long-term motor success.
The motor results of early esotropia surgery are generally satisfactory; the sensory results are often disappointing. Detecting poor prognostic factors improves operative results.
婴儿性内斜视的特征是斜视角度大且明显的感觉扭曲。虽然运动手术结果令人满意，但感觉结果仍不尽如人意。
我们的工作旨在描述手术管理方法、运动和感觉结果以及其预后因素。
回顾性研究了 68 例婴儿性内斜视患者。所有患者均接受了全面的眼科检查和感觉运动评估。所有患者均在全身麻醉下由同一位外科医生进行手术。我们评估了运动和感觉结果。研究的预后因素包括发病年龄、治疗延迟、弱视严重程度、斜视偏转角和垂直元素的存在。
平均最小偏转角为 38.6±13.2D。73.5%的患者存在下斜肌亢进，5.8%的患者存在分离性垂直偏斜。双侧内直肌后退是最常进行的手术（60.2%的病例）。总体成功率为 94.11%。没有患者获得立体视觉。多变量逻辑回归分析显示，术前眼压（p=0.007）、术后即刻结果（p<0.001）和手术剂量（p=0.009）与长期运动成功相关。
早期内斜视手术的运动结果通常令人满意，感觉结果往往令人失望。检测不良预后因素可改善手术结果。
