Changes in Hypermetropic Spectacle Correction after Surgery in Partially Accommodative Esotropia

PURPOSE: To investigate the characteristics of successfully weaning patients off of glasses and the change in hypermetropic spectacle correction required for maintaining orthotropia using an analysis of surgery results of patients with partially accommodative esotropia. METHODS: We reviewed the medical records of 104 patients who underwent standard surgery for correcting partially accommodative esotropia. In total, 64 patients who had follow-up periods of at least 2 years were included. The patients were divided into 2 groups: 28 patients who were asked to discontinue their hyperopic glasses (glasses-discontinued group) and 36 patients who still needed hyperopic glasses (glasses-maintained group). We investigated the age at first visit and at surgery, total angle of deviation and residual angle of deviation with correction before surgery, weaning time of hyperopic glasses, follow-up period, and the time at which the hyperopic glasses were discontinued in the glasses-discontinued group. RESULTS: There were no statistically significant differences in the age at first visit and at surgery as well as the duration of postoperative follow-up between both groups. The total esodeviated angle without hyperopic correction of the glasses-discontinued group was significantly lower than that of glasses-maintained group (37.4PD:46.7PD, p < 0.05); there were no significant differences in the remaining esotropic angle after hyperopic correction. The average hyperopic degree in the glasses-discontinued group was significantly lower than that in the glasses-maintained group (+3.0D:+4.7D, p < 0.05), there were no significant differences in the weaning time of hyperopic glasses between both groups. CONCLUSIONS: The esodeviated angle without hyperopic correction was smaller and hyperopic degree was lower in the glasses-discontinued group than in the glasses-maintained group after surgery for partially accommodative esotropia. Therefore, it might be helpful to predict the postoperative possibility to discontinue glasses in the patients with partially accommodative esotropia.

Changes in Hypermetropic Spectacle Correction after Surgery in Partially Accommodative Esotropia

PURPOSE: To investigate the characteristics of successfully weaning patients off of glasses and the change in hypermetropic spectacle correction required for maintaining orthotropia using an analysis of surgery results of patients with partially accommodative esotropia. METHODS: We reviewed the medical records of 104 patients who underwent standard surgery for correcting partially accommodative esotropia. In total, 64 patients who had follow-up periods of at least 2 years were included. The patients were divided into 2 groups: 28 patients who were asked to discontinue their hyperopic glasses (glasses-discontinued group) and 36 patients who still needed hyperopic glasses (glasses-maintained group). We investigated the age at first visit and at surgery, total angle of deviation and residual angle of deviation with correction before surgery, weaning time of hyperopic glasses, follow-up period, and the time at which the hyperopic glasses were discontinued in the glasses-discontinued group. RESULTS: There were no statistically significant differences in the age at first visit and at surgery as well as the duration of postoperative follow-up between both groups. The total esodeviated angle without hyperopic correction of the glasses-discontinued group was significantly lower than that of glasses-maintained group (37.4PD:46.7PD, p < 0.05); there were no significant differences in the remaining esotropic angle after hyperopic correction. The average hyperopic degree in the glasses-discontinued group was significantly lower than that in the glasses-maintained group (+3.0D:+4.7D, p < 0.05), there were no significant differences in the weaning time of hyperopic glasses between both groups. CONCLUSIONS: The esodeviated angle without hyperopic correction was smaller and hyperopic degree was lower in the glasses-discontinued group than in the glasses-maintained group after surgery for partially accommodative esotropia. Therefore, it might be helpful to predict the postoperative possibility to discontinue glasses in the patients with partially accommodative esotropia.

The Clinical Characteristics of V-Pattern Exotropia Without Inferior Oblique Muscle Overaction

PURPOSE: To compare the surgical outcome between V-pattern intermittent exotropia without inferior oblique overaction and comitant intermittent exotropia. METHODS: The authors of the present study investigated 15 patients (V-pattern group) who had standard horizontal surgery with half-tendon width vertical transposition and 36 patients (Comitant group) with unilateral rectus muscle recession/resection. Preoperative visual acuity, presence of amblyopia, abnormal head posture, stereoacuity, amount of exotropia, and duration of postoperative diplopia were recorded. Surgical success was defined as final alignment of orthophoria or less than 10 PD orthophoria. RESULTS: The frequency of good stereoacuity with 80 sec of stereoacuity or more was higher in the V-pattern group (73.3%) than in the Comitant group (33.3%) (Fisher's exact test, p = 0.01). One case of V-pattern showed consecutive esotropia for 1 year postoperatively. Exotropia recurred in 2 patients in the V-pattern group (13.3%), and in 4 patients in the Comitant group (11.1%) 1 year postoperatively. Surgical success rates were statistically significant higher in the V-pattern group (86.7%) as compared to the Comitant group (58.3%) on final follow-up (Fisher's exact test, p = 0.04). CONCLUSIONS: V-pattern exotropia patients without inferior oblique overaction who had standard horizontal surgery with half-tendon width vertical transposition showed a lower recurrence rate of exotropia than patients with comitant intermittent exotropia.