@article {1302170,
	title = {Long-term Surgical Outcomes for Large-angle Infantile Esotropia},
	journal = {Am J Ophthalmol},
	volume = {189},
	year = {2018},
	month = {2018 May},
	pages = {155-159},
	abstract = {PURPOSE: To report the long-term surgical outcomes for a cohort of children with large-angle infantile esotropia.

DESIGN: Multicenter, nonrandomized clinical study.

METHODS: Setting: Two tertiary-care pediatric hospitals.

STUDY POPULATION: Children with large-angle (>=55 prism diopters) infantile esotropia.

INTERVENTION: Surgical treatment of infantile esotropia.

MAIN OUTCOME MEASURE: Success rate at final follow-up (postoperative deviation <= 10 prism diopters and no need for retreatment).

RESULTS: A total of 88 patients with large-angle infantile esotropia were treated during the 13-year study period. Treatment was bilateral medial rectus muscle recessions in 70 patients, botulinum toxin-augmented surgery in 15 patients, and 3-muscle surgery in 3 patients. After a mean follow-up of 40~months, 20 patients (23\%) had a successful outcome compared to 68 treatment failures (77\%). Of the 68 treatment failures, 59 had residual or recurrent esotropia and 9 had sequential exotropia. On multivariate logistic regression, treatment modality was the only factor significantly associated with a successful outcome. Specifically, patients treated with botulinum toxin-augmented surgery were more likely to have a successful outcome compared to patients treated with bilateral medial rectus muscle recessions. For the 26 patients (30\%) who underwent retreatment, the mean number of procedures was 2.1, and 7 (27\%) had a deviation of <=10 prism diopters at final follow-up.

CONCLUSIONS: The overall success rate for treatment of large-angle infantile esotropia was poor in this cohort, with most failures owing to recurrent or residual esotropia. Botulinum toxin-augmented surgery was associated with a higher success rate at final follow-up.},
	issn = {1879-1891},
	doi = {10.1016/j.ajo.2017.11.006},
	author = {Wan, Michael J and Chiu, Hedva and Shah, Ankoor S and Hunter, David G}
}
