Augmented bimedial rectus muscles recession in acute acquired concomitant esotropia associated with myopia

Roda, Matilde; Pellegrini, Marco; Rosti, Alessandro; Fresina, Michela; Schiavi, Costantino

doi:10.1016/j.jcjo.2020.10.006

Cited by 15 publications

(11 citation statements)

References 18 publications

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“…Indeed, patients can mask the esodeviation due to strong fusional reserve, which became evident during the cover test with the typical "eat-up prisms". Therefore, we suggest performing a very dissociative cover test, inviting the patient to alternatively fix a distance and a near stimulus to unmask the total deviation and thus avoid surgical hypo-corrections [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…Type III AACE, also known as Bielschowsky esotropia (BE), was described first by Von Graefe in 1864 and then by Bielschowsky in 1922 as a sudden onset esotropia with diplopia characterized by an inner deviation at distance and maintenance of fusion at near, no evidence of paralysis, conserved binocular fusion and associated with myopia of 5 diopters (D) or less. Hoyt and Good modified this definition and underlined the relationship with various degrees of myopia, and the constant and equal deviation at both near and distance fixations [ 3 ]. Although the aetiology is still not wholly understood, it has been recently associated with excess close work in adults, which could produce an imbalance of the convergence and divergence tone of the extraocular muscle [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Epidemiology, clinical features, and surgical outcomes of acute acquired concomitant esotropia associated with myopia

et al. 2023

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Purpose To analyze epidemiology, clinical features, and surgical outcomes of type III acute acquired concomitant esotropia (Bielschowsky esotropia (BE)). Methods The medical charts of patients diagnosed with acquired concomitant esotropia between 2013 and 2021 were reviewed. Assessed data were age, gender, age at diplopia onset, age at the diagnosis, refraction, visual acuity, neuroimaging, diplopia onset, angle of deviation, stereopsis, surgical procedure, amount of surgery, and relapse of diplopia after surgery. Moreover, we investigated the correlation between the use of electronic devices and the onset of diplopia. Results One hundred seventeen patients (mean age 35.07 ± 15.81 years) were included in the study. The mean delay to the diagnosis was 3.29 ± 3.62 years. Myopia range was 0 to 17 diopters spherical equivalent. 66,3% spent more than 4 hours a day using laptops, tablets, or smartphones at the onset of diplopia, and 90,6% presented a subacute onset. None showed neurologic signs or symptoms. Patients who underwent surgery were ninety-three, with a rate of surgical success of 93.6%, and a relapse rate of 17.2%. A negative correlation resulted between pre-operative deviation and age at diagnosis (ρ = -0.261; p<0.05), whereas factors associated with surgical failure were older age at diplopia onset (p = 0.042) and longer delay between onset and diagnosis (p = 0.002). Conclusion We registered an outstanding increase in prevalence of BE, which could be related to the exponential increase in the use of electronic devices for professional, educational, and recreational purposes. A prompt diagnosis and an augmented dose of surgery allows good motor and sensory results.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Epidemiology, clinical features, and surgical outcomes of acute acquired concomitant esotropia associated with myopia

et al. 2023

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“…The treatment was surgical in both our cases, with postoperative restoration of binocular function and resolution of the diplopia [ 3 - 8 ]. Two different surgical procedures were chosen, bilateral medial rectus (MR) recession in one case, and unilateral medial rectus recession combined with lateral rectus resection (R&R) in the other, with no proof of superiority of one surgical procedure over the other [ 14 , 24 - 28 ].…”

Section: Discussionmentioning

confidence: 99%

Management of acute acquired comitant esotropia in children

Dragomir

Merticariu

2023

rjo

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“…However, surgical treatment is usually necessary to achieve orthotropia and eliminate diplopia for patients with large-angle deviations of AACE, especially in patients without a significant neurological disease. Recently, the incidence of patients with AACE is increasing maybe due to excessive application of near vision linked to the display devices [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…Bilateral medial rectus (MR) recession or unilateral medial rectus recession and lateral rectus resection (R&R) are the two most common procedures performed for the surgical treatment of esotropia. There is no evidence of superiority of one surgical procedure [ 6 ]. The surgical methods may be different according to the surgeon’s preference.…”

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confidence: 99%

Surgical Outcomes of Medial Rectus Recession and Lateral Rectus Resection for Large-angle Deviations of Acute Acquired Concomitant Esotropia

Kang

Kim

2021

Korean J Ophthalmol

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Purpose This study aimed to evaluate the surgical outcomes of unilateral medial rectus recession and lateral rectus resection (R&R) for patients with large-angle deviations of acute acquired concomitant esotropia (AACE) without a neurological disease. Further, we have also suggested the surgical dosage of R&R for large-angle deviations of AACE. Methods This was a retrospective study of patients with AACE who underwent surgery and followed up after surgery for at least 6 months between September 2016 and March 2020. Among them, patients with ocular deviations of ≥30 prism diopters (PD) who underwent unilateral R&R were included. Results Seventeen patients with AACE were enrolled in this study (mean age, 23.5 years; four females). The mean amount of deviation was 40.00 PD at distance and near (range, 30–55 PD). Fifteen patients (88.2%) had myopia. The mean interval between the initial visit and surgery was 7.7 months (range, 4–20 months). All included patients had resolved diplopia after the surgery. Most patients with decreased stereoacuity displayed stereoacuity recovery after surgical treatment. At the final visit (mean follow-up period, 12.8 months), the mean angle of esodeviation was 0.82 PD (range, 6–0 PD) at distance and 0.47 PD (range, 4–0 PD) near. No patient displayed over-correction or adduction limitations in the operated eye. Conclusions The unilateral R&R procedure presented favorable surgical outcomes for patients with large-angle deviations of AACE. These results and proposed surgical dosage guidelines may be useful for surgeons in planning the surgical treatment of large-angle deviations of AACE.

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Augmented bimedial rectus muscles recession in acute acquired concomitant esotropia associated with myopia

Cited by 15 publications

References 18 publications

Epidemiology, clinical features, and surgical outcomes of acute acquired concomitant esotropia associated with myopia

Epidemiology, clinical features, and surgical outcomes of acute acquired concomitant esotropia associated with myopia

Management of acute acquired comitant esotropia in children

Surgical Outcomes of Medial Rectus Recession and Lateral Rectus Resection for Large-angle Deviations of Acute Acquired Concomitant Esotropia

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