Infantile Esotropia: Clinical Features and Results of Bilateral Medial Rectus Recession

Introduction: To define the characteristics of infantile esotropia and evaluate the results of bilateral medial rectus recession in infantile esotropia. Methods: A retrospective review was performed on medical charts of patients diagnosed with infantile esotropia. All patients underwent an ophthalmological examination to detect the conditions that accompany infantile esotropia. Patients with two years of age or older and without fixation preference or amblyopia underwent bilateral medial rectus recession. Results: There were a total of 117 patients with infantile esotropia patients. Infantile esotropia was accompanied by inferior oblique hyperfunction, fixation preference, cross-fixation, pseudoabduction deficit, pattern deviations, nystagmus, dissociated vertical deviation, convergence insufficiency, and abnormal head position. Approximately forty percent of the patients compatible with visual acuity measurements had amblyopia. Bilateral medial rectus recession decreased the mean esotropia from 43.1 +/- 15.3 to 7.8 +/- 12.8 prism diopters (PD) in 65 patients. Postoperatively, 41 patients had an ocular alignment within 10 PD of orthotropia, 22 patients showed undercorrection and 2 overcorrection. Conclusion: The characteristics of infantile esotropia in our study are substantially consistent with those of early reports, except for convergence insufficiency. This study also showed that bilateral medial rectus recession appears to have a high percentage of undercorrection in short-term postoperative follow-up in infantile esotropia.