Time and factors affecting the direction of Re-drift in essential infantile Esotropia

Kun Hoo Na, Yoonae A. Cho, Seung Hyun Kim

Research output: Contribution to journalArticle

Abstract

Purpose: To investigate the development pattern and related factors of postoperative re-drift in infantile esotropia. Methods: A total of 112 patients with infantile esotropia who underwent surgery before 3 years of age were included. Surgical outcomes were divided into (1) consecutive exotropia: more than 8 prism diopters (PD) of exodeviation; (2) recurrent esotropia: more than 8 PD of esodeviation; and (3) monofixation syndrome: maintenance of deviations within 8 PD. The occurrence rate, time of onset, and associated factors of the re-drift were evaluated. Results: At a mean follow-up of 9.5 years, consecutive exotropia developed in 37 patients (33.0%) and recurrent esotropia in 43 patients (38.4%). Whereas 76.7% of total recurrent esotropia cases were identified within postoperative 1 year, consecutive exotropia occurred constantly over 10 years postoperatively. The mean time to consecutive exotropia development from surgery was 78.6 months, greater than that of recurrent esotropia development (8.9 months) (P < 0.001). In multinomial logistic regression using monofixation syndrome as the reference category, fixation preference before surgery (odds ratio [OR]: 6.64, 95% confidence interval [CI]: 2.07 to 21.32) and the rate of myopic progression (OR: 15.07 per -1.00 D/year, 95% CI: 1.23 to 184.86) were associated with consecutive exotropia, whereas increase in the angle of esodeviation on postoperative day 1 (OR: 1.15, 95% CI: 1.04 to 1.26) was correlated with recurrent esotropia. Conclusions: This study demonstrates a difference between the development pattern of exotropic and esotropic drift after infantile esotropia surgery. Detailed preoperative assessment and close postoperative observation of deviations and refractive status will help to determine surgical outcomes of infantile esotropia.

Original languageEnglish
Pages (from-to)93-99
Number of pages7
JournalJournal of Pediatric Ophthalmology and Strabismus
Volume55
Issue number2
DOIs
Publication statusPublished - 2018 Mar 1

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Esotropia
Exotropia
Odds Ratio
Confidence Intervals
Direction compound
Logistic Models
Maintenance
Observation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Ophthalmology

Cite this

Time and factors affecting the direction of Re-drift in essential infantile Esotropia. / Na, Kun Hoo; Cho, Yoonae A.; Kim, Seung Hyun.

In: Journal of Pediatric Ophthalmology and Strabismus, Vol. 55, No. 2, 01.03.2018, p. 93-99.

Research output: Contribution to journalArticle

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abstract = "Purpose: To investigate the development pattern and related factors of postoperative re-drift in infantile esotropia. Methods: A total of 112 patients with infantile esotropia who underwent surgery before 3 years of age were included. Surgical outcomes were divided into (1) consecutive exotropia: more than 8 prism diopters (PD) of exodeviation; (2) recurrent esotropia: more than 8 PD of esodeviation; and (3) monofixation syndrome: maintenance of deviations within 8 PD. The occurrence rate, time of onset, and associated factors of the re-drift were evaluated. Results: At a mean follow-up of 9.5 years, consecutive exotropia developed in 37 patients (33.0{\%}) and recurrent esotropia in 43 patients (38.4{\%}). Whereas 76.7{\%} of total recurrent esotropia cases were identified within postoperative 1 year, consecutive exotropia occurred constantly over 10 years postoperatively. The mean time to consecutive exotropia development from surgery was 78.6 months, greater than that of recurrent esotropia development (8.9 months) (P < 0.001). In multinomial logistic regression using monofixation syndrome as the reference category, fixation preference before surgery (odds ratio [OR]: 6.64, 95{\%} confidence interval [CI]: 2.07 to 21.32) and the rate of myopic progression (OR: 15.07 per -1.00 D/year, 95{\%} CI: 1.23 to 184.86) were associated with consecutive exotropia, whereas increase in the angle of esodeviation on postoperative day 1 (OR: 1.15, 95{\%} CI: 1.04 to 1.26) was correlated with recurrent esotropia. Conclusions: This study demonstrates a difference between the development pattern of exotropic and esotropic drift after infantile esotropia surgery. Detailed preoperative assessment and close postoperative observation of deviations and refractive status will help to determine surgical outcomes of infantile esotropia.",
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