The Clinical Effect of Augmented Surgery for Partially Accommodative esotropia

Kim, Jong Cheon; Park, Soo Chul; Park, Chan

Abstract

In the partially accommodative esotropia, conventional operation based only on the nonaccommodative angle often results in undercorrection. To decrease the incidence of postoperative undercorrection, the authors augmented the amount of the surgical correction to be the average of the near deviation with and without correction. In this study we compared augmented surgery to conventional surgery in patients who underwent bilateral medial rectus recessions. 36 patients with hypermetropia of +2.50 or more, were retrospectively studied. The follow up on each group was at least 3 months. Of the 18 patients in nonaugmented group, 8(44%) had postoperative deviations of 10 prism diopters or less and 10(56%) showing a undercorrection. Of the 18 patients of augmented surgery, 14(78%) had postoperative deviations of 10 prism diopters or less and 2(11%) was exotropic while wearing full hyperopic correction. But of the 2 patients with a consecutive exodeviation, 1 was corrected to orthophoria by reducing the spectacle correction and 1 after removing spectacles. The overall success rate of 89% for the augmented surgery is much higher than that of the conventional surgery. We conclude that the augmented surgery provides better postoperative alignment than the conventional surgery and recommend this augmented surgery in partially accommodative esotropia.