ABSTRACT
Objective
To identify and examine factors that affect postoperative binocularity in children
diagnosed with acquired nonaccommodative esotropia (ANAET).
Design
Retrospective chart review.
Participants
Thirty-four pediatric patients who received surgery for ANAET by 1 surgeon (I.M.)
at the Ivey Eye Institute, University of Western Ontario (London, Ont.).
Methods
A multivariate logistic regression analysis was performed to evaluate the effect of
the following factors on achieving stereopsis postoperatively: age at onset of esotropia
(AO), duration of misalignment (DOM), presence of A/V pattern, recent intermittency
of esotropia, and presence of dense amblyopia.
Results
Forty-one percent of all patients achieved stereoacuity of 100 seconds of arc or better.
AO was found to be the only factor significantly associated with postoperative stereopsis
(adjusted odds ratio = 1.063, P<0.05). None of the children with AO who were younger than 30 months regained bifoveal
fixation regardless of their DOM.
Conclusions
Age of onset appears to play a crucial role on postoperative functional outcome in
children with ANAET. Delayed surgery in children with an age of onset beyond 30 months
did not seem to be detrimental to regaining bifoveal fixation.
Résumé
Objet
Identification et examen des facteurs affectant la binocularité postopératoire chez
les enfants ayant un diagnostic d'ésotropie non accommodative acquise (ETNAA).
Nature
Examen rétrospectif de dossiers.
Participants
34 patients en pédiatrie qui ont subi une chirurgie pour ETNAA effectuée par un chirurgien
(I.M.) au Ivey Eye Institute, University of Western Ontario.
Méthodes
Une analyse logistique de régression à plusieurs variables a été effectuée pour évaluer
l'effet des facteurs suivants sur le résultat de stéréopsie postopératoires : ãge
au début de l'ésotropie (AD), durée du désalignement (DDM), comportement A/V, intermittence
récente de l'ésotropie et présence d'amblyopie dense.
Résultats
41 % de tous les patients ont atteint la stéréopsie à 100 secondes d'arc ou mieux.
Le AD s'est avéré õtre le seul facteur associé de façon significative à la stéréopsie
postopératoire (ratios de probabilité corrigés = 1,063, p<0,05). Aucun des enfants
ayant un AD de moins de 30 mois n'a regagné de fixation bifovéale quelle que fut leur
DDM.
Conclusion
L'ãge du début semble jouer un rôle crucial sur le résultat fonctionnel postopératoire
chez les enfants atteints d'ETNAA. Le report de la chirurgie chez les enfants dont
l'ãge au début de l'ésotropie est au-delà de 30 mois ne semble pas nuire au regain
de la fixation bifovéale.
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Article info
Publication history
Accepted:
September 11,
2012
Received in revised form:
August 20,
2012
Received:
April 6,
2012
Footnotes
Preliminary results were presented at the Canadian Ophthalmological Society Annual Meeting in Quebec City, Que., June 2010.
Identification
Copyright
© 2012 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
