Abstract
Objective: The study’s aims were to evaluate the success of bimedial rectus recession as a primary surgical procedure for patients with congenital esotropia; describe the demographic data of the study group; and compare surgical success with patient age at the time of surgery.Method: A retrospective review of 52 patients with congenital esotropia ≥ 50∆ (prism dioptres) was conducted. All patients underwent bimedial rectus recession and were followed-up postoperatively for a minimum of 6 months.Results: The study period was from January 1992 to September 2003. Fifty-two patients were included in the study group. The pre-operative angle of deviation ranged from 50∆–85∆. Patient ages ranged from 15 months to 22 years, with a mean of 5.3 years and a median of 4 years. The gender distribution was 42% male (n = 20) and 58% female (n = 28). Surgery was successful (within 10∆ of orthophoria) in 77% (n = 40), a partial success (10∆–20∆ from orthophoria) in 17% (n = 9) and a failure (> 20∆ from orthophoria) in 6% (n = 3). No statistically significant relationship was found between surgical success and patient age at the time of surgery.Conclusion: The study confirmed that bilateral medial rectus recession, performed as a primary procedure for patients with large-angle (> 50∆) congenital esotropia, has a high success rate. This finding corresponds with the outcomes of similar international studies.
Highlights
Esotropias are the most common form of strabismus, making up more than 50% of paediatric ocular deviations.[1,2] Congenital esotropias are the most common type of esotropia
The present work is a retrospective study of 52 patients with large-angle congenital esotropia who were operated on at St John Eye Hospital (St John)
The present study demonstrates a good surgical outcome for patients with a large-angle esotropia undergoing bimedial rectus recession as a primary procedure
Summary
Esotropias are the most common form of strabismus, making up more than 50% of paediatric ocular deviations.[1,2] Congenital esotropias are the most common type of esotropia. The prevalence in the general population of congenital esotropia is approximately 1%.1. In patients with neurological and developmental abnormalities, the prevalence of esotropia may be as high as 30%.2. In patients with congenital esotropia, the deviation is usually more than 35∆ (prism dioptres) in size, comitant and unchanged between near and far gaze. Seventy-five per cent of patients have an inferior oblique overaction, usually developing by 2 years of age, which produces a V-pattern on examination. 75% of patients may have dissociated vertical deviation.[2]
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