Revisiting Posterior Fixation Sutures Surgery: Unveiling Novel Approaches for Primary Management of Diverse Esotropia Cases

• Published in: Ophthalmology and therapy 2023-12, Vol.12 (6), p.2989-2999
• Main Authors: Freitas-da-Costa, Paulo, Alves, Hélio, Santos-Silva, Renato, Falcão-Reis, Fernando, Breda, Jorge, Magalhães, Augusto
• Format: Article
• Language: English
• Subjects: Esotropias; Faden operation; Internal Medicine; Medicine; Medicine & Public Health; Ocular motility disorder; Ophthalmology; Orbital pulley; Original Research; Strabismus
• ISSN: 2193-8245; 2193-6528
• DOI: 10.1007/s40123-023-00792-z

Introduction Strabismus, specifically esotropia, presents a significant challenge in ophthalmic surgery, while several treatment options exist. This study aims to evaluate the results of posterior fixation sutures (PFS) on the medial rectus as a primary approach for some types of esotropia. Methods The medical records of consecutive patients who underwent surgery for esotropia over 11 years and had at least 1 year of follow-up were reviewed retrospectively. Patients were classified into one of three types of deviation: infantile (IE), partially accommodative (PAE) and basic (BE) esotropias. An alignment within 16 prism diopters (PD) of orthotropia was a successful outcome. Results A total of 404 patients were included: 67 IE, 180 PAE and 157 BE. Before surgery, a deviation greater than 30 PD was present in 88.1% and 80.1%, and a deviation greater than 50 PD was present in 66.5% and 52.9% of patients (near and distance, respectively). In the BE group, PFS was the baseline surgery in a smaller number of cases (75%) compared to the other two groups (versus 86.6% [IE] and 88.3% [PAE], p  = 0.002). The need for an additional procedure was significantly higher in the infantile esotropia group (44.8% vs. 18.9% and 24.8%, p