Long-Term Stability of Alignment in the Monofixation Syndrome

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Abstract
From a collection of 328 patients with congenital esotropia, 80 patients were identified who had a minimum 4-year follow-up after surgical alignment within 8 prism diopters (pd) of orthophoria. These patients were subdivided into two groups: the M.S. group (38 patients) demonstrated the monofixation syndrome; the NO M.S. group (42 patients) did not have monofixation. The alignment of patients in each group was followed over time. After 17.5 years, 74% of patients in the M.S. group maintained alignment within 8 pd of orthophoria. In the NO M.S. group, only 45% were well aligned after 14 years. The mean time to loss of stability was significantly shorter for the NO M.S. group (P<0.005). Our findings suggest achievement of the monofixation syndrome improves but does not guarantee stability of ocular alignment.

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