Relationship between stereopsis outcome and timing of surgical alignment in infantile esotropia

Abstract

To clarify the relationship between stereopsis outcome and timing of surgical alignment in infantile esotropia. The medical records of otherwise healthy patients with infantile esotropia who underwent surgery by 8years of age were divided into the following groups according to age at time of surgery: very early surgery (≤8months), early surgery (>8 to ≤24months) and late surgery (>24months). Binocular response and stereopsis were compared between groups. A total of 76 patients were included: 22 in the very early group, 30 in the early group, and 24 in the late group. Binocular response at near was found in 96% of the very early group and in 80% of the early group, significantly higher than the 50% of the late group (P<0.001 and P<0.05 [Dunn test], resp.). Stereopsis was present in 77% of the very early group, significantly higher than the 20% of the early group and 13% of the late group (P<0.001 [Dunn test]). A significant correlation was also found between age (months) at surgery and stereopsis (seconds) outcome (logarithmic fit: y=2539.4ln(x)+147.2; R2=0.2691; P<0.001). In this study cohort, earlier surgery was associated with better binocularity in patients with infantile esotropia. Our results suggest that very early surgery, at ≤8months, can improve the chance for postoperative stereopsis, with the caveat that some infants might have had spontaneous esotropia resolution.