Abstract:

Objective To investigate surgical methods and effect of the children's consecutive esotropia. Design Retrospective case series． Participants 22 patients from 4 to 11 years-old (average 7.2±2.1 years-old ) with consecutive esotropia which persisted over 6 months after exotropia surgery were analyzed retrospectively. Methods The choice of operative methods depended on the abduction impairment, angle of the difference and traction test. All surgeries were combined with adjustable suture technique. Clinical success was defined as disappeared diplopia and abnormal head position, mean deviation within ±10 PD as long term follow up. The patients were followed up for average 16.1±5.3 months. Main Outcome Measures Preoperative deviation, mobility evaluation, eye movement, and abnormal head position, binocular stereopsis and fusion were performed as well as post-operative residual deviation and binocular function. Results 8 patients less than +30 PD in primary position with abduction impairment were treated with advancement at insertion of lateral rectus muscle. 3 patients of +30~+40 PD in primary position with abduction impairment were treated with partial resection at insertion of lateral rectus muscle. 5 patients more than +40 PD in primary position with abduction impairment were treated with advancement of lateral rectus combined with recession of medial rectus; 6 patients less than +30 PD in primary position without limited abduction were treated with recession of medial rectus. At the last follow-up deviation was （-3.5±-6.4） PD. 5(22.7%) cases were suture-adjusted. All patients had no limited abduction. The success rate was 86.4% (19/22). Binocular stereopsis and fusion were significantly improved. Conclusion Surgical treatment for consecutive esotropia is effective. For abduction impairment, advancement at insertion of lateral rectus muscle should be the first choice. Postoperatively, deviation, binocular stereopsis and fusion were significantly improved. Adjustable suture technique can reduce the probability of re-operation.  (Ophthalmol CHN, 2016, 25: 46-50)

Key words: consecutive esotropia/surgery, binocular vision