A comparative trial of Gobin's method versus conventional surgery for refractive/accommodative esotropia uncorrected by non-surgical methods.

INTRODUCTION AND PURPOSE: Gobin's theory of strabismus emphasizes the importance of diagnosis and correction of oblique muscle dysfunction when operating on the horizontal muscles to correct eso- and exodeviations in infancy. The purpose of this study was to compare outcomes for the two schools for this type of strabismus.

METHODS

Two cohorts of infants, one treated by the classical approach of correcting horizontal deviation alone except in the presence of "significant" oblique dysfunction, while the other treated by Gobin's techniques, have been followed for a minimum of six years.

RESULTS

The infants managed according to Gobin's method achieved "statistically significantly" better final results in terms of a higher percentage of cases achieving binocular vision, 81% versus 44% for the classical approach. They also had a reduced incidence of functional amblyopia after completion of treatment, 11% versus 39%.

CONCLUSION

Gobin's theories and techniques deserve careful attention from all surgeons involved in treating infants with strabismus and amblyopia.