Influence of timing of initial surgery for infantile esotropia on the severity of dissociated vertical deviation.

PURPOSE: The purpose of this study was to clarify whether the timing of initial surgery for infantile esotropia contributes to better sensory outcomes and to the severity of dissociated vertical deviation (DVD).

METHODS: This retrospective study examined 55 children, aged 8 years and younger, who underwent esotropia surgery. Based on age at the time of the surgery, patients were divided into the very early surgery group (birth to 8 months, N = 14), early surgery group (9-24 months, N = 23) and late surgery group (25 months and older, N = 18). Sensory and motor outcomes of the three groups were statistically evaluated.

RESULTS: No significant differences in the incidences of DVD were noted among the three groups at the final visit. However, all DVDs of the very early surgery group were latent, whereas 38.9% of the DVDs for both near and distance of the late surgery group were manifest. Significant differences were found among the three groups for the proportion of patients with manifest DVD, latent DVD and without DVD, and for the incidence of additional surgery for manifest DVD (p < 0.05, G-test).

CONCLUSION: Early surgery for infantile esotropia decreases the severity of DVD and lowers the need for an additional operation for DVD.