The Longterm Postoperative Alignment and Binocularity of Partially Accommodative Esotropia

Lee, Ju youn; Kim, Jung Kwon; Cho, Yoonae A

Abstract

In this study, 63 patients underwent unilateral or bilateral medial rectus recession for nonaccommodative portion of partially accommodative esotropia and were followed up for more than 2 years after surgery.The nonaccommodative portion was measured by wearing the least hyperopic glasses for the best corrected visual acuity.The amount of recession of medial rectus was determined considering the patients'characteristics such as fusional ability, amount of hyperopia, AC/A ratio, visual acuity, and quality of muscle at forced duction test. The mean follow-up period was 5.2 +/-2.53 (2~13)years.Seven (11.2%) patients underwent surgery for recurrent esotropia due to deterioration. Consecutive exotropia did not occur.At the last visit all eyes were aligned with favorable stereopsis.Forty eight patients (76.2%)had deviation up to 8 PD of orthophoria and 15 patients showed esophoria greater than 8 PD, with fusional ability and stereoacuity of 40~400 seconds of arc (sec).Preoperatively, only 28.1%of the patients had gross stereopsis of 200~3000 sec.Postoperatively, 98.6%of the patients showed good stereopsis better than 800 sec : 75.5%better than 200 sec and 76%normal stereopsis more than 40 sec. This study revealed that individualized surgery for nonaccommodative component, and meticulous pre-and postoperative management resulted in good alignment and binocularity during long-term follow-up.Recurrent esotropia due to detrioration occurred more than consecutive exotropia after surgery.