Second esotropia surgery may be necessary in children with developmental delay

Despite a low initial success rate with esotropia surgery in children with developmental delay, additional procedures may achieve satisfactory results, according to a study.

Data were collected over a 16-year period on 24 children who had a mean angle of preoperative esotropia of 49.8 ∆D. Surgical success, which was the main outcome measure for the study, was qualified as esotropia or exotropia of 10 ∆D or less.

Mean age of patients was 2.8 years, ranging from 0.8 to 10 years. Mean follow-up was 5.3 years.

After one operation, surgical success was recorded in nine of the children (37.5%). Of the 15 failures, 10 (66.6%) were undercorrected and five (33.3%) developed consecutive exotropia. Eight of the 15 failures had a second procedure, and final overall surgical success was achieved in 63% of children.