Surgical outcomes of acute acquired comitant esotropia of adulthood

Abstract

Background: To analyze the surgical outcomes for adult patients diagnosed with acute acquired comitant esotropia (AACE). Methods:Medical records of 21 patients who had undergone surgery for AACE were retrospectively analyzed. The main outcome measures were the final motor and sensory success rate after surgery and factors affecting motor and sensory outcomes. Motor success was considered alignment within 8 prism diopter (PD) at both near and distance and sensory success was stereoacuity ≥60 sec/arc. Results:The preoperative mean esodeviation angles were 33.0 ± 11.6 PD at distance and 32.6 ± 10.8 PD at near. The mean period of postoperative follow up was 8.1 ± 4.5 months (range 3-8 months). The postoperative mean esodeviation angles at final follow-up time were 4.1 ± 5.7 PD at 2 distance and 3.9 ± 5.6 PD at near. The surgical motor success rate at final follow-up was 76.2% (16/21). The sensory success rate at final follow-up was 55.5% (11/21). The factor affecting the motor outcome was the type of surgery (p < 0.05). The factor affecting sensory outcome was postoperative follow-up time (p < 0.05). Conclusions: Surgery type appears to affect surgical motor outcomes in adults with AACE. Although the sensory outcome was favorable, it seems that regaining bifoveal fixation takes time.

Non-adjustable surgery for acute acquired comitant esotropia under general anesthesia

“…Surgical studies regarding AACE have revealed favorable surgical results [2,14,15]. In order to improve surgical results, variable methods such as increasing surgical dose, preoperative prism adaptation, consideration of surgical methods, and adjustable surgery could be considerate [4,15,16]. Williams and Hoyt reported that stereopsis could be achieved after surgical treatment of AACE without neurologic abnormalities [17].…”

Sensory eye dominance following surgically correction for acute acquired concomitant esotropia of adulthood

“…[8][9][10] Studies on the surgery outcome of only adults with AACE are rare, but most of them consistently demonstrated that the AACE of adulthood has high rate of success in re-establishing good stereoscopic vision. 4,11 This makes sense since the acute esotropia occurs during adulthood and thus binocular functions develop completely which could be regained after the surgery.…”