J Korean Ophthalmol Soc.  2016 Nov;57(11):1752-1758. 10.3341/jkos.2016.57.11.1752.

Surgical Outcomes Dependent on the Amount of Hyperopia in Infantile Esotropia

• Kim YJ
• Shin KH
• Paik HJ

• KMID: 2357731
• DOI: http://doi.org/10.3341/jkos.2016.57.11.1752

Abstract

PURPOSE
In the present study, short-term and long-term surgical outcomes dependent on the amount of hyperopia in patients with infantile esotropia were analyzed.
METHODS
In this study, 80 patients with infantile esotropia who underwent both medial rectus recession from 2007 to 2011 and followed up for at least 36 months were retrospectively examined. The patients were divided into two groups according to the degree of hyperopia: ≥ +3.0 D (high hyperopia [HH], n = 59 patients) and < +3.0 D (non-high hyperopia [NH], n = 21 patients). Clinical characteristics analyzed included surgical success rate and dose-response relationship at the 3-month and 3-year postoperative follow-ups.
RESULTS
Initial preoperative alignment (NH: 44.8 ± 10.2 PD, HH: 42.7 ± 11.6 PD, p = 0.450), surgical success rates (NH: 69.5% (41/59), HH: 71.4% (15/21), p = 0.837), under-correction rates (NH: 23.7% (14/59), HH: 9.5% (2/21), p = 0.191) and over-correction rates (NH: 6.8% (4/59), HH: 19.1% (4/21), p = 0.138) were not statistically significantly different between the NH and HH groups. A tendency towards a larger dose-response relationship was observed with HH (NH: 3.9 PD/mm, HH: 4.3 PD/mm) at the 3-month postoperative follow-up, but was not significant (p = 0.105). At the 3-year postoperative follow-up, exodrift was in progress and the dose-response relationship was significantly higher in the HH group than NH group (NH: 3.9 PD/mm, HH: 4.9 PD/mm, p = 0.010). A difference between the groups with amblyopia was observed (NH: 8.5% (5/59), HH: 23.8% (5/21), p = 0.146), although without statistical significance.
CONCLUSIONS
The surgical success rate of infantile esotropia was not statistically associated with the amount of hyperopia. There was no statistical association between the dose-response relationship and amount of hyperopia at the postoperative 3-month follow-up, but a statistical association was found in the high dose-response relationship in the HH group at the postoperative 3-year follow-up. Therefore, the conventional amount of recession or muscle resection should be modified in high hyperopic (≥ +3.0 D) infantile esotropia, and long-term postoperative follow-up is necessary.

Keyword

Dose-response relationship; High hyperopia; Infantile esotropia; Medial rectus recession; Refractive error

MeSH Terms

Amblyopia
Esotropia*
Follow-Up Studies
Humans
Hyperopia*
Refractive Errors
Retrospective Studies

Figure

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  Figure 1. Post-op angle of deviation – patients with refractive error ≥+5.0 D. Post-op exodrift was more in patients with refractive error ≥+5.0 D. PD = prism diopters; POD = post-op day.

Reference

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