Long-term follow-up of congenital esotropia in a population-based cohort

PURPOSE To report the long-term outcomes of a population-based cohort of children diagnosed with congenital esotropia during a 30-year period. METHODS The medical records of all patients diagnosed with congenital esotropia as residents of Olmsted County, MN, from January 1, 1965, through December 31, 1994, were retrospectively reviewed. RESULTS A total of 130 children were diagnosed during the 30-year period at a median age of 7.4 months with a mean deviation of 30(Delta). During a median follow-up of 11.9 years, 126 patients underwent a mean of 1.8 strabismus surgeries. The risk for undergoing a second surgery was significantly greater in patients with a larger presenting angle (p = 0.017) and a younger age at first surgery (p = 0.006). The Kaplan-Meier rate of having a second surgery was 51% at 10 years and 66% at 20 years. For those with 6 weeks or more of follow-LIP from the final surgery, last examined at a mean age of 15.1 years, 42 of 94 (45%) were within 8(Delta) of orthotropia and 30 of 98 had some level of stereopsis (<= 3000 arcsec). CONCLUSIONS In this population-based study of children with congenital esotropia, a second surgery was necessary in half the patients after 10 years and was more likely in those patients with a larger presenting angle and a younger age at first surgery. Approximately half of the patients were within 8(Delta) of orthotropia and one-third had measurable stereopsis after a mean of 10.9 years of follow-up. (J AAPOS 2009;13:8-12)