Surgical Outcome of Esotropia Considering the Functional Equator

Purpose: To predict the surgical outcome of esotropia by considering the axial length of the functional equator in addition to the preoperative deviation angle. Methods: Forty patients with partially accommodative esotropia or infantile esotropia who had received bilateral medial rectus muscle recession were studied for axial length of the functional equator in addition to the preoperative near deviation angle. Patients were followed for more than 12 months. All patients were checked for near and far deviation angles at postoperative 1 week, 1 month, 6 months and 12 months. Results: Seventeen of the 40 patients had partially accommodative esotropia and 23 had infantile esotropia. The overall mean age was 4.1 years and the mean follow-up period was 14.1 months (12-18 months). Preoperative near and far deviation angles were respectively 30.6±8.1PD and 25.6±12.2PD in partially accommodative esotropia patients and 44.9±11.7PD and 43.1±13.5PD in infantile esotropia patients. The amount of mean medial rectus muscle recession was 5.15±0.87 mm in the former group and 6.26±1.12 mm in the latter. At the postoperative 12-month follow-up, 20 (86.9%) partially accommodative esotropia patients showed successful outcomes and 3 (13.1%) had under correction; the outcome was successful in 15 (88.2%) infantile esotropia patients while 2 (11.8%) showed under correction. Conclusions: A successful outcome was achieved in patients with partially accommodative esotropia and infantile esotropia with consideration of the functional equator.