Long-Term Study of Accommodative Esotropia

Abstract

This study demonstrates that a high AC/A relationship increases the likelihood of deterioration of accommodative esotropia, supporting the earlier studies, as well as the accuracy of this database. It also represents a new model for the utilization of clinical trials' bias-reduction principals in the analysis of retrospective data.

The Analysis of AC/A Ratio in Nonrefractive Accommodative Esotropia Treated with Bifocal Glasses

“…The gradual decrease of the AC/A ratio with age in nonrefractive accommodative esotropia was revealed in this study, which corresponds well with observations from previous studies [9,10]. The rates of decrease were 0.01 per 1 month, which were similar in both groups in this study.…”

“…The average bifocal discontinuation age of 10.8 years in this study may indicate that surgical treatment of nonrefractive accommodative esotropia can be delayed until this age. Other reports have revealed good postoperative outcomes following strabismus surgery at even younger ages, but a second surgery was required more frequently in younger patients [10,11]. In this study, there were six patients who received strabismus surgery because of uncontrolled esotropia, even with bifocal lenses, during follow-up.…”

“…Treatment with bifocals to correct residual near esodeviation is a well-established and popular method for patients with nonrefractive accommodative esotropia [10,18]. In this study, about one-third of patients with nonrefractive accommodative esotropia were able to stop using bifocal lenses during follow-up without surgery.…”

The Analysis of AC/A Ratio in Nonrefractive Accommodative Esotropia Treated with Bifocal Glasses

“…The gradual decrease of the AC/A ratio with age in nonrefractive accommodative esotropia was revealed in this study, which corresponds well with observations from previous studies [9,10]. The rates of decrease were 0.01 per 1 month, which were similar in both groups in this study.…”

“…The average bifocal discontinuation age of 10.8 years in this study may indicate that surgical treatment of nonrefractive accommodative esotropia can be delayed until this age. Other reports have revealed good postoperative outcomes following strabismus surgery at even younger ages, but a second surgery was required more frequently in younger patients [10,11]. In this study, there were six patients who received strabismus surgery because of uncontrolled esotropia, even with bifocal lenses, during follow-up.…”

“…Treatment with bifocals to correct residual near esodeviation is a well-established and popular method for patients with nonrefractive accommodative esotropia [10,18]. In this study, about one-third of patients with nonrefractive accommodative esotropia were able to stop using bifocal lenses during follow-up without surgery.…”

Treatment of Younger Patients with Accommodative Esotropia

“…Bifocal lenses that correct the full cycloplegic refraction with the addition of between +2.00 D and +3.00 D are the commonest treatment method for high AC/A AET. [1,2,26] In the present study, bifocal lenses were somewhat controversial in the treatment of high AC/A ratio AET. The Whitman study (2016) reported that, although bifocal lenses were widely used to treat AET, there was no evidence to suggest that they showed better outcomes in children with high AC/A ratio AET than single-vision lenses or surgery.…”

Changes in refractive error in patients with accommodative esotropia after being weaned from hyperopic correction

“…In addition, both patients initially had a high AC/A ratio. Because a high AC/A ratio can be a risk factor for decompensated ET,32 we suggest that a patient who has a high AC/A ratio requires more attention.…”

The Analysis of AC/A Ratio in Nonrefractive Accommodative Esotropia Treated with Bifocal Glasses

“…The gradual decrease of the AC/A ratio with age in nonrefractive accommodative esotropia was revealed in this study, which corresponds well with observations from previous studies [9,10]. The rates of decrease were 0.01 per 1 month, which were similar in both groups in this study.…”

“…The average bifocal discontinuation age of 10.8 years in this study may indicate that surgical treatment of nonrefractive accommodative esotropia can be delayed until this age. Other reports have revealed good postoperative outcomes following strabismus surgery at even younger ages, but a second surgery was required more frequently in younger patients [10,11]. In this study, there were six patients who received strabismus surgery because of uncontrolled esotropia, even with bifocal lenses, during follow-up.…”

“…Treatment with bifocals to correct residual near esodeviation is a well-established and popular method for patients with nonrefractive accommodative esotropia [10,18]. In this study, about one-third of patients with nonrefractive accommodative esotropia were able to stop using bifocal lenses during follow-up without surgery.…”

Treatment of Younger Patients with Accommodative Esotropia

“…Bifocal lenses that correct the full cycloplegic refraction with the addition of between +2.00 D and +3.00 D are the commonest treatment method for high AC/A AET. [1,2,26] In the present study, bifocal lenses were somewhat controversial in the treatment of high AC/A ratio AET. The Whitman study (2016) reported that, although bifocal lenses were widely used to treat AET, there was no evidence to suggest that they showed better outcomes in children with high AC/A ratio AET than single-vision lenses or surgery.…”

Changes in refractive error in patients with accommodative esotropia after being weaned from hyperopic correction

“…In addition, both patients initially had a high AC/A ratio. Because a high AC/A ratio can be a risk factor for decompensated ET,32 we suggest that a patient who has a high AC/A ratio requires more attention.…”

The Analysis of AC/A Ratio in Nonrefractive Accommodative Esotropia Treated with Bifocal Glasses

“…The gradual decrease of the AC/A ratio with age in nonrefractive accommodative esotropia was revealed in this study, which corresponds well with observations from previous studies [9,10]. The rates of decrease were 0.01 per 1 month, which were similar in both groups in this study.…”

“…The average bifocal discontinuation age of 10.8 years in this study may indicate that surgical treatment of nonrefractive accommodative esotropia can be delayed until this age. Other reports have revealed good postoperative outcomes following strabismus surgery at even younger ages, but a second surgery was required more frequently in younger patients [10,11]. In this study, there were six patients who received strabismus surgery because of uncontrolled esotropia, even with bifocal lenses, during follow-up.…”

“…Treatment with bifocals to correct residual near esodeviation is a well-established and popular method for patients with nonrefractive accommodative esotropia [10,18]. In this study, about one-third of patients with nonrefractive accommodative esotropia were able to stop using bifocal lenses during follow-up without surgery.…”

Treatment of Younger Patients with Accommodative Esotropia

“…Bifocal lenses that correct the full cycloplegic refraction with the addition of between +2.00 D and +3.00 D are the commonest treatment method for high AC/A AET. [1,2,26] In the present study, bifocal lenses were somewhat controversial in the treatment of high AC/A ratio AET. The Whitman study (2016) reported that, although bifocal lenses were widely used to treat AET, there was no evidence to suggest that they showed better outcomes in children with high AC/A ratio AET than single-vision lenses or surgery.…”

Changes in refractive error in patients with accommodative esotropia after being weaned from hyperopic correction

“…In addition, both patients initially had a high AC/A ratio. Because a high AC/A ratio can be a risk factor for decompensated ET,32 we suggest that a patient who has a high AC/A ratio requires more attention.…”