Session: Poster session A

Early Versus Late Surgery for Infantile Esotropia in Chilean Population

Cristian SALGADO², Rodolfo GARRETÓN¹, Francisco FARFÁN¹, Álvaro MORGADO², Federica SOLANES²

¹Resident of Ophthalmology, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile
²Specialist in Pediatric Ophthalmology and Strabismus, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile

INTRODUCTION

Infantile esotropia begins approximately at 6 months of age. The management is mainly surgical. There are studies that concluded that early surgery would have a better result, however, pre surgical measurement is complex and can fluctuate. The objective of the study is to compare surgical success when operating before and after 18 months of age.

METHODS

Retrospective study. We searched in the surgery database for all patients with strabismus, recording those with infantile esotropia. Pre and post operative characteristics, surgeries performed and whether the first one was before or after 18 months of age were recorded. Surgical success was compared between both groups, defined as an esotropia less than 10 diopters or an exotropia less than 5 diopters.

RESULTS

30 patients with infantile esotropia were found. The mean age of diagnosis was 23.3 ± 35 months. At the first consultation, 7 had inferior oblique hyperfunction, 5 had dissociated vertical deviation and 1 had nystagmus. The average time from diagnosis to surgery was 4.4 ± 3.8 months. 17 patients were operated before 18 months and 13 after. Within the early surgery group, 7 were successful with 1 surgery, while 4 in the late group (p = 0.4). The early group had an average follow-up of 4.7 years, 1.6 operations, 10 had surgical success at the last consultation (58.8%) and of those evaluated for stereopsis, it was present in 1 patient, while the late group had an average follow-up of 3.2 years, 1.2 surgeries, 6 had success at the last consultation (45.2%), and of those evaluated for stereopsis, it was present in 1 patient.

CONCLUSION

There was a trend that operating before 18 months of age would have a higher frequency of success compared to performing it after this age, however, this was not statistically significant. Of those evaluated for stereopsis, it was present in 1 patient in each group. The early surgery group had a slightly higher average number of surgeries compared to the late group.