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

PURPOSE

To answer this important outcome question.

SUBJECTS AND 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.