Keywords [eng] |
Strabism, esotropia, comitant, incomitant, botulinum toxin, recession, resection, rectus, stereopsis, binocularity, gaze, convergent, amblyopia, hyperopia, optokinetic, dissociated vertical deviation, cross-fixation, plication, visual acuity. |
Abstract [eng] |
Infantile esotropia is a type of ocular motility disorder characterized by an inward turning of one or both eyes, also known as "crossed eyes." Infantile esotropia is esotropia that occurs in a neurologically normal child during the first 6 months of life. Although the term "congenital esotropia" has been used interchangeably, the condition is rarely present at birth. Therefore, from here on the term “infantile esotropia” will be used. The deviation angle is constant and large (>30 PD). There are several surgical techniques available to treat infantile esotropia. Although bilateral medial rectus recessions greater than 5 mm have been an acceptable treatment, many surgeons still prefer other techniques such as three or four-muscle surgeries, botulinum toxin augmentation, etc. The main purpose of this literature analysis is to review and analyze the different surgical techniques that are used to treat this condition in addition to evaluating possible augmentations and factors affecting the postoperative surgical outcome during follow-ups. The overall conclusions are that operative treatment before the age of one bears the best long-term outcome and that procedures augmented by non-invasive methods result in better stereopsis. Currently, the choice of treatment is merited to the ophthalmic surgeon and his preference and further depends on each individual case. Additional multicenter prospective studies need to be done to properly identify a gold standard method of therapy. |