Medium-Term Outcomes of Three Horizontal Muscle Surgery in Large-Angle Infantile Esotropia

Abstract

The success rate of the three horizontal muscle surgeries appears to be high enough in medium-term follow-up in patients with large-angle infantile esotropia. Overcorrection that necessitates additional horizontal muscle surgery does not seem to be significant in the medium term, according to this study.

Outcomes of esotropia surgery in Saudi Arabia: An audit from a single center

“…These findings are generally similar to those in other studies 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13. The reoperation rate was 10.1%, which is within the range of rates reported internationally (6–23.8%) in studies of patients with variable etiology of ET and of different ages 2, 4, 7, 8, 9. We still do not have any data concerning the long-term (≥10-year) follow-up outcomes in the KSA, in this study 75% of cases were followed for ≥5 years.…”

“…Surgeries to correct ET are reported to have successful outcomes in 48.5–89.7% of cases globally 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13. The large variability in success rates is due to differences in the post-operative angle from orthophoria used to assess outcome, the etiology of ET, the type of procedure, the length of post-operative follow-up, and other associated risk factors.…”

Management of infantile esotropia

“…Orthotropia to within 10 prism diopters or less was achieved in 78% of patients with a median follow up of 32 months (5-63 months). No overcorrections occurred and 22% had reoperation for residual esotropia [14]. There are limitations with this study including: retrospective nature, low number of patients, no standard surgical dosage was used, cyclovertical procedure performed at the same time in one patient, and surgery was performed relatively late.…”

“…Although it has been shown that bilateral medial rectus recessions greater than 5 mm are an acceptable treatment, many surgeons still opt for three to four muscle surgery for the treatment of infantile esotropia [11][12][13][14]. There are two studies in the recent literature that retrospectively looked at surgical outcomes.…”

Transplante autólogo de músculo ocular extrínseco para tratamento cirúrgico de estrabismos sensoriais grandes

“…Dessa forma, operam-se os dois olhos. (1)(2)(3) Isso porque se evita recuar excessivamente um músculo para além de seu ponto de tangência com a esclera, para que não se decomponha sua força, que deve ser rotacional, em componentes também translacionais, que só serviriam para perturbar a dinâmica dos movimentos oculares, causando restrições à rotação do globo, desvios incomitantes e enoftalmia -esta última com efeitos deletérios sobre a simetria das rimas palpebrais. (4) Alguns estudos vêm mostrando que pode ser feita a técnica de recuo-ressecção um pouco mais generosa e, ainda assim, não são causadas restrições importantes às rotações oculares e nem movimentos translacionais -quer essas operações sejam feitas sob anestesia geral, peribulbar ou tópica.…”