Surgical Outcomes and Factors Related to Their Success of Infantile Esotropia in a Tertiary Hospital: A Retrospective Study

Worapot Srimanan Ophthalmology Division, Phramongkutklao Hospital, Bangkok, ThailandCorrespondence: Worapot Srimanan, Ophthalmology Division, Phramongkutklao Hospital, 315 Ratchawithi Road, Thung Phayathai Subdistrict, Ratchathewi, Bangkok, Thailand, Tel +66 2-763-9300, Fax +66 2-354-9309, Email [email protected]: This study aims to evaluate the outcomes of surgical intervention for infantile esotropia at a tertiary care hospital.Patients and Methods: Medical records of patients with esotropia who underwent surgical correction at our tertiary hospital between January 2013 and June 2023 were retrospectively analyzed. Patient demographics, preoperative and postoperative ocular alignment, surgical techniques employed, complications or reoperations, and factors related to successful surgery were analyzed.Results: The study included 77 participants with an average age of 9.54 ± 10.87 years at the time of surgery. Postoperatively, 71.4% (55/77) patients achieved successful alignment, which was defined as an ocular deviation of ≤ 10 prism diopters (PD), at the final follow-up. The average follow-up period was 12 months, during which no complications were noted. Reoperation was required in 15.6% (12/77) patients. Multivariate logistic regression revealed that having a smaller preoperative deviation of < 50 PD positively influenced the success of strabismus surgery (adjusted odds ratio, 7.13; 95% CI, 2.04– 24.86).Conclusion: The surgical correction of infantile esotropia in a tertiary care setting yielded favorable alignment outcomes in most cases, with no complications and a low reoperation rate. A preoperative angle of < 50 PD emerged as a prognostic factor for successful surgical outcomes in this population. Further studies with longer follow-up periods are recommended to evaluate the long-term stability of these outcomes and identify additional influencing factors.Plain language summary: This study reviewed the outcomes of surgery for infantile esotropia, a condition where one or both eyes turn inward. We analyzed medical records of patients who underwent surgical correction for esotropia at a tertiary care hospital between January 2013 and June 2023. We collected information about patient demographics, eye alignment before and after surgery, the types of surgeries performed, any complications, and factors related to successful outcomes.The study included 77 patients, who had an average age of ~9.5 years at the time of surgery. After surgery, 71.4% (55 out of 77) of patients achieved successful eye alignment, defined as an eye deviation of 10 prism diopters or less. Patients returned for follow-up after an average of 12 months, and no complications were reported. However, 15.6% (12 out of 77) of patients required reoperation. Our analysis showed that patients with a smaller initial eye deviation (less than 50 prism diopters) were likely to have successful outcomes.In conclusion, surgery for infantile esotropia in our hospital resulted in good alignment in most cases, with no complications and a low rate of repeat surgeries. Having a smaller initial eye deviation strongly predicted the success of the surgery. Further research with longer follow-up periods is needed to determine the long-term outcomes and identify other factors that may influence outcomes.Keywords: esotropia, strabismus, surgery, success, factor