Deciion Analyi With Markov Procee upport Early urgery for Large-Angle Infantile Eotropia

Purpoe To ae tradeoff in time pent with aligned viual axe or tereopi and riked reoperation between three trategie for the treatment of large-angle infantile eotropia: firt urgery at 6, 24, or 48 month of age. Deign Deciion analyi. Method We imulated three hypothetic cohort of children with thi condition until their eighth year. Potential achievement of tereopi, the diagnoi of diociated vertical divergence or inferior oblique overaction, and variou complication were modeled. Probability etimate were obtained from a comprehenive literature review. Analye aimed to determine the trategy that wa aociated with longer time pent with aligned eye and/or tereopi and fewer reoperation. Reult Eight-year-old children are expected to pend 72.6 v 58.0 v 37.8 month with aligned eye and 26.8 v 9.0 v 1.5 month with tereopi and to receive on average 1.76 v 1.67 v 1.46 urgerie, if they firt underwent operation at 6 v 24 v 48 month, repectively. Children at 8 year are expected to have tereopi at the rate of 36.1% v 17.2% v 5.1%, repectively. Operation at 6 month intead of 48 month i expected to yield an additional 9% of total follow-up time in health tate with eye alignment and 11% in health tate with tereopi, per 5% increae in rik for extra operation (5% and 7%, repectively, per 5% increae in rik for operation at 6 v 24 month). Wide-range enitivity analye and long-term projection point to the ame direction. Concluion Given the benefit/rik tradeoff, it i probably warranted to attempt to correct large-angle infantile eotropia a early a poible.