Monocular surgery to correct large-angle esotropia: a 10-year follow-up study

To conduct a 10-year follow-up on the surgical correction of large-angle esotropia using monocular surgery, verifying surgical stability over time in both adults and children, and investigating the presence of consecutive exotropia among reviewed patients.

Methods:

The angles of deviation in primary position were measured using prism cover testing in patients with good vision in both eyes and the Krimsky method in those with severe amblyopia. Among the 46 patients who underwent surgery, 40 were evaluated 10 years post-surgery. Student’s t-test and McNemar’s test were used for statistical analyses.

Results:

No significant differences in the angles of deviation in primary position were found between measurements taken 6 months and 10 years post-surgery (p=0.922), as well as between children and adults (p=0.767). Among the 40 reviewed patients, only five presented with exotropia, all of which were small (the largest being XT 15^Δ). Therefore, large consecutive exotropia over time was not observed.

Conclusion:

Our results suggest that monocular surgery to correct large-angle esotropia using large medial rectus recessions and broad lateral rectus resections was viable and safe in both adults and children over short and long terms.

Keywords:
Strabismus; Esotropia; Exotropia; Oculomotor muscles; Refractive erros

Patient’s initials	Gender	Age	Visual acuity		Pre-surgical angle^Δ	Surgery performed		Measurements of angles of deviation in 6-month follow-up			Post-surgical angle^Δ 6-month follow-up	Post-surgical angle^Δ 10-year follow-up
Patient’s initials	Gender	Age	OD	OS	Pre-surgical angle^Δ	Recession (mm)	Resection (mm)	Adduction	PP	Abduction	Post-surgical angle^Δ 6-month follow-up	Post-surgical angle^Δ 10-year follow-up
LBP	F	40	0.40	0.80	75	5	10	-	-	-	ET 8	ET 5
MHCS	F	43	0.20	1.00	95	7	10	ET 12	ET 12	ET 15	ET 12	ET 10
JJAS	M	6	0.80	0.60	50	5	9	ET 10	ET 12	ET 20	ET 12	ET 20
LV	F	31	0.40	1.00	70	6	10	-	-	-	ET 8	ET 4
ACV	F	10	1.00	1.00	55	6	7	ET 4	ET 12	ET 14	ET 12	ET 2
PPG1	M	58	C.D.	1.00	65	8	9	ET 2	ET 7	ET 17	ET 7	ET 15
TCSS	F	4	0.90	0.90	65	7	10	XT 18	ET 2	ET 7	ET 2	ET 4
POS	F	8	1.00	1.00	60	6	10	ET 16	ET 20	ET 25	ET 20	ET 30
PHF	M	16	1.00	1.00	70	8	10	XT 4	ET 8	ET 8	ET 8	ET 10
JIG^* * angles were measured using the Krimsky method (other patients were measured using the alternate prism cover test).	M	39	0.05	1.00	55	7	8	XT 10	ET 5	ET 5	ET 5	ET 5
AB^* * angles were measured using the Krimsky method (other patients were measured using the alternate prism cover test).	M	29	H.M.	1.00	75	8	10	XT 10	ET 8	ET 16	ET 8	ET 18
SRS	M	27	1.00	0.6	75	8	9	-	-	-	ET 8	ET 12
MASP	F	44	0.40	1.00	65	8	10	ET 10	ET 20	ET 16	ET 12	ET 14
VAA	M	32	0.80	0.80	80	10	10	-	-	-	ET 5	ET 5
DMC	M	33	1.00	0.80	70	8	9	ET 4	ET 14	ET 14	ET 14	ET 8
SS	F	14	1.00	1.00	50	7	8	ET 2	ET 6	ET 4	ET 6	ET 12
GSS	M	11	1.00	1.00	65	8	9	ET 4	ET 12	ET 6	ET 12	ET 2
JRB	M	45	1.00	1.00	70	8	9	ET 8	ET 16	ET 32	ET 16	XT 4
RNSC	M	5	0.80	0.90	50	6	9	0	ET 12	ET 14	ET 12	ET 6
RGXS	M	8	0.20	1.00	70	7	10	-	-	-	ET 15	ET 20
TBG1	F	6	0.05	0.80	50	7	8	0	ET 6	ET 6	ET 6	XT 10
ADP	M	47	1.00	1.00	70	8	10	XT 5	ET 15	ET 25	ET 15	ET 20
FBL	M	8	1.00	1.00	50	7	8	0	ET 8	ET 8	ET 8	ET 8
JJA	F	45	0.40	1.00	100	10	10	ET 0	ET 27	ET 40	ET 27	ET 5
SDS^* * angles were measured using the Krimsky method (other patients were measured using the alternate prism cover test).	M	40	0.80	H.M.	55	7	9	XT 10	XT 5	0	XT 5	ET 8
JS	F	12	1.00	1.00	62	8	10	XT 8	XT 4	XT 5	XT 4	ET 8
OPS	M	39	0.80	1.00	75	9	10	XT 5	ET 6	ET 12	ET 6	ET 6
PHFB^* * angles were measured using the Krimsky method (other patients were measured using the alternate prism cover test).	M	8	0.05	1.00	70	9	10	XT 30	0	ET 14	XT 5	XT 15
VNJ	M	10	0.80	0.80	57	8	8	-	-	-	ET 5	ET 10
JPC	M	37	0.80	0.80	58	8	8	0	ET 5	ET 5	ET 5	ET 6
BAM^* * angles were measured using the Krimsky method (other patients were measured using the alternate prism cover test).	F	13	1.00	0.05	80	10	10	XT 18	ET 8	ET 12	ET 8	ET 5
TOL	F	9	1.00	0.80	64	9	9	XT 14	XT 6	XT 2	XT 6	XT 4
LMRS	F	43	1.00	0.80	70	9	10	ET 4	ET 10	ET 20	ET 10	ET 8
MLS	F	12	1.00	1.00	90	10	10	ET 12	ET 32	ET 30	ET 32	ET 35
WAS	M	24	1.00	1.00	50	8	6	XT 10	ET 8	ET 10	ET 8	ET 2
JCAP	M	8	1.00	1.00	60	8	9	XT 8	ET 4	0	ET 4	XT 4

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E-mail: abo@cbo.com.br

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[1] Corresponding author: Edmilson Gigante. Avenida Washington Luiz, 874 - 1º andar - Presidente Prudente, SP - 19015-150 - Brazil. E-mail: adgigante@gmail.com