comparative study of prism adaptation versus augmented surgery formula in the management of acquired comitant esotropia

This study compares two methods of surgical augmentation, namely prism adaptation and the augmented surgery formula, in the management of acquired comitant esotropia. Forty patients were included in the study. These were divided equally into two groups: Group A [Augmented Surgery Formula Group] and Group P [Prism Adaptation Group]. Group A patients underwent surgery based on an augmented surgery formula, defined as the average of the near deviation without correction and the distance deviation with correction. Group P patients had preoperative prism adaptation, at the end of which they were classified as prism adaptation responders [fusers] or nonresponders [nonfusers]. All group P patients underwent surgery for the prism-adapted angle. Among group P patients, 6 [30%] were classified as prism responders, while 14 [70%] were nonresponders. The three-month motor success rate was significantly higher in group P [90%] than in group A [55%], [z statistic=2.69, P=0.05]. On the other hand, the sensory success rate was insignificantly higher in group A [45%] than in group P [65%], [z statistic=1.29, p>0.05]. Prism adaptation is superior to the augmented surgery formula in precisely determining the surgical target angle in acquired comitant esotropia. The former has a special indication in non-accommodative esotropia, whereas the latter is the only feasible option in cases of esotropia exceeding 40 delta with correction. To maximize the benefit of prism adaptation, it is recommended that all prism-adapted patients [responders and nonresponders] undergo surgery for the prism-adapted angle

management of amblyopia

The lines of treatment of amblyopia include occlusion, red filter, penalization and physiological diplopia. The aim of this study is to evaluate the role of occlusion in the management of amblyopia