The Long-term Follow-up Results of Patients with Partially Accommodative Esotropia after Conventional Surgery

Choi, Byung Ryong; Kwon, Jung Yoon

Abstract

PURPOSE
To evaluate the changes of clinical features after long-term follow-up observation on patients with partially accommodative esotropia who had undergone conventional surgery. METHODS: Thirty-five patients who maintained orthophoria for at least one year duration after surgery were evaluated. The amount of surgery was measured based on the near angle of deviation after full hyperopic correction. The comparison was made based on the best corrected visual acuity, refractive errors, degree of stereopsis and ocular positions before and after surgery. RESULTS: The mean spherical equivalent was +4.46 D before surgery and +3.66 D at the final examination. Among a total of 70 eyes, the best corrected visual acuity of 0.6 or less was seen in 16 before surgery, and in 12 at the final examination. The average angle of deviation was 50.14 PD before correction and 34.43 PD after correction. The Titmus stereotest after surgery was 80 sec of arc in 6, and even 40 sec of arc in 2 out of the 35 patients. At the final examination, 29 of the 35 patients revealed stable orthophoria, but exophoria, in a range of 15-25 PD, developed in 6 patients. Of these 6, 4 had anisometropic amblyopia, and 1 had bilateral high hyperopia of 8.0 D with refractive amblyopia. CONCLUSIONS: Long-term follow-up observation is essential after surgery for partially accommodative esotropia due to fear of the gradual development of consecutive exotropia, particularly in amblyopia cases, even though acceptable initial postoperative orthophoria has been achieved.