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To define the prevalence and time course of significant changes in angle of deviation during the first months after the diagnosis of i nfantile esotropia and to determine whether long-term alignment and sensory out comes differ when surgical alignment is performed on infants with stable vs unst able angles of deviation. Prospective cohort study. setting: Institutional and c linical practice. patient population: Newly diagnosed patients with infantile es otropia (N=208). observation procedure: Preoperative measurements of the angle o f deviation on the initial visit and at approximate six-week intervals until su rgery was performed. main outcome measures: Ocular alignment at six weeks, one y ear, and four years postoperative and stereoacuity at age five to nine years. Ov erall, 57%of infants had an esodeviation on the second visit that was within 10 prism diopters (p.d.) of the deviation measured on the initial visit (stable gr oup), 33%had an increase of 10 p.d. or more (unstable group), and 11%had a dec rease of 10 p.d. or more. Among the 127 patients with additional preoperative vi sits, many switched between the stable and unstable categories during follow-up . Long-term, stable and unstable preoperative alignment groups had similar post operative motor alignment, re-operation rates, rates of prescription of hyperop ic, or bifocal spectacle correction and stereoacuity. It may not be necessary to wait for a “stable”angle of esodeviation before surgery since both alignment and sensory outcomes were similar for stable and unstable groups.
To define the prevalence and time course of significant changes in angle of deviation during the first months after the diagnosis of i nfantile esotropia and to decide whether long-term alignment and sensory out of differ differ when surgical alignment is performed on infants with stable vs unstability angles of deviation. Prospective cohort study. setting: Institutional and c linical practice. patient population: Newly diagnosed patients with infantile esotropia (N = 208). observation procedure: Preoperative measurements of the angle of deviation on deviation of the initial visit and at approximate six -week intervals until su rgery was performed. main outcome measures: Ocular alignment at six weeks, one y ear, and four years postoperative and stereoacuity at age five to nine years. Ov erall, 57% of infants had an escape on the second visit that was within 10 prism diopters (pd) of the deviation measured on the initial visit (stable group), 33% had an increase of 10 pd or more (unstable group Among the 127 patients with additional preoperative vi sits, many switched between the stable and unstable categories during follow-up. Long-term, stable and unstable preoperative alignment groups similar post operative motor alignment, re-operation rates, rates of prescription of hyperop ic, or bifocal spectacle correction and stereoacuity. It may not be necessary to wait for a “stable” angle of esodeviation before surgery since both justification and sensory outcomes were similar for stable and unstable groups.