The prevalence of reoperation and related risk factors among patients with congenital esotropia

J Pediatr Ophthalmol Strabismus. 2013 Jan-Feb;50(1):53-9. doi: 10.3928/01913913-20120804-11.


Purpose: To determine the prevalence rate and related risk factors of reoperation among patients with congenital esotropia.

Methods: One hundred fifty-seven children with congenital esotropia were divided into two groups after at least one operation: children with deviation within 10 PD (n = 89; success group) and those with deviation greater than 10 PD or history of reoperation (n = 68; failure group). The relationship of risk factors such as age at first operation and primary congenital esotropia of less than 30 or more than 50 PD and accompanying factors such as inferior oblique muscle overaction (> +1), dissociated vertical deviation, lateral rectus muscle underaction, and A-V pattern with reoperation were studied. Final sensory status of children 5 years and older was evaluated by Worth 4-dot and Titmus tests.

Results: Reoperation was indicated in 32.4% of children who had residual esotropia greater than 15 PD after 3 months following their first operation. Congenital esotropia greater than 30 PD (P = .002) and lateral rectus muscle underaction of −1 to −2 (P < .005), were statistically different between the two groups. Initial operation at younger than 3 years was more likely to achieve gross stereopsis in children 5 years and older (P = .032).

Conclusion: Congenital esotropia greater than 30 PD and lateral rectus muscle underaction were found to be risk factors of reoperation.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Esotropia / congenital*
  • Esotropia / physiopathology
  • Esotropia / surgery*
  • Female
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Oculomotor Muscles / physiopathology
  • Oculomotor Muscles / surgery*
  • Ophthalmologic Surgical Procedures
  • Prevalence
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • Risk Factors
  • Vision, Binocular / physiology
  • Young Adult