Comparison of recurrent esotropia and consecutive exotropia with horizontal muscle reoperation in infantile esotropia.

PURPOSE: We investigated the clinical and demographic factors associated with horizontal muscle reoperation due to recurrent esotropia or consecutive exotropia in infantile esotropia.

METHODS: One hundred forty-two patients with infantile esotropia who received at least 3 years of follow-up after their first surgery between January 2004 and December 2012 were included in this study. The patients were divided into 2 groups according to the reoperation, and the reoperation group was further subdivided into 2 groups [recurrent esotropia (RET) and consecutive exotropia (CXT)]. Age and prism diopters (PD) at the first operation, duration of misalignment expression, gender, preterm birth, presence of amblyopia and anisometropia, preoperative refractive error, nystagmus, fundus extorsion, and other type of strabismus were evaluated as risk factors for the reoperation.

RESULTS: The mean length of follow-up was 6.1 ± 2.4 years after surgery, and the reoperation group comprised 65 patients (RET: 31; CXT: 34). The mean length of follow-up did not differ significantly between the groups, but the age at the time of the first surgery, did (RET: 1.8 ± 0.7 years; CXT: 2.4 ± 0.9 years; P = .003). In addition, the duration of RET or CXT expression differed significantly between the groups (RET: 1.9 ± 1.1 years; CXT: 4.1 ± 2.2 years; P < .001), as did the reoperation time (RET: 4.9 ± 1.3 years; CXT: 7.6 ± 2.2 years; P < .001). Younger age at the time of the first surgery and fundus extorsion before the first surgery were significant risk factors for RET as compared with CXT.

CONCLUSION: This study showed that age at the time of the first surgery and at the time of reoperation for RET was younger than for CXT in infantile esotropia.