RANDOM-DOT STEREOACUITY FOLLOWING SURGICAL-CORRECTION OF INFANTILE ESOTROPIA

Surgical correction of infantile esotropia prior to age 2 is associate d with a higher prevalence of fusion and stereopsis than surgical corr ection after 2 years of age. The advantages and disadvantages of surgi cal intervention at the early or late end of this window have been deb ated in the literature. In the present study, random dot (RD) stereoac uity outcomes were evaluated in order to determine whether a binocular sensory benefit is associated with early or late surgery. Participant s were 73 healthy children enrolled in a prospective study of visual d evelopment in infantile esotropia. All children had initial surgical c orrection at 5 to 16 months of age. RD stereoacuity was evaluated at a pproximately 5 years of age (59.7 +/- 14.9 months). Overall, 41.1% of children demonstrated RD stereopsis. The percentage of children demons trating RD stereopsis was not significantly different among groups tha t were surgically corrected at 5 to 8 months (43.8%), 9 to 12 months ( 47.4%), and 13 to 16 months (31.8%). However, among those children who achieved RD stereopsis, the prevalence of foveal (<60 sec) or macular (61 to 200 sec) stereoacuity was significantly higher among those who had surgery at 5 to 8 months (42.9%; Z=2.06, p<0.02) or 9 to 12 month s (55.6%; 2=2.38, p<0.009) than among those who had surgery at 13 to 1 6 months (0.0%). Although surgical correction of infantile esotropia d uring the first year of life is not associated with a higher prevalenc e of RD stereopsis, it is associated with better RD stereoacuity among those children who achieve stereopsis following surgery.