The relationship between preoperative alignment stability and postoperative motor outcomes in children with esotropia

PURPOSE To examine the effect of preoperative alignment stability on postoperative motor outcomes in children who underwent surgery for esotropia. METHODS One hundred sixty-seven subjects (68 with infantile esotropia and 99 with acquired esotropia) aged less than 6 years had surgery after completing 18 weeks of follow-up as part of an observational study. Preoperative alignment was classified as stable, uncertain, or unstable, based on measurements taken at baseline and every 6 weeks for 18 weeks. Distance alignment measured by prism and alternate cover test was compared among stability classification groups at 6 weeks and 6 months after surgery. RESULTS Among subjects with infantile esotropia, median 6-week postoperative deviation was 2(Delta), 6(Delta), and 2(Delta) for subjects with stable, uncertain, and unstable preoperative alignment, respectively (p = 0.73 for stable vs unstable). Median 6-month postoperative deviation was 1(Delta), 9(Delta), and 1(Delta) for stable, uncertain, and unstable, respectively (p = 1.00 for stable vs unstable). Among subjects with acquired esotropia, median 6-week postoperative deviation was 6(Delta), 4(Delta), and 4(Delta) for subjects with stable, uncertain, and unstable preoperative alignment, respectively (p = 0.69 for stable vs unstable). Median 6-month postoperative deviation was 8(Delta), 4(Delta), and 6(Delta) for stable, uncertain, and unstable, respectively (p = 0.22 for stable vs unstable). CONCLUSIONS Postoperative alignment at 6 weeks and 6 months appears similar in children with stable versus unstable preoperative esotropia. Nevertheless, our finding should be interpreted with caution due to small sample size. (J AAPOS 2009;13:335-338)