Long-Term Changes of Hyperopic Refractive Error in Refractive Accommodative Esotropia

ABSTRACT

PURPOSE: To analyze the long-term changes of hyperopic refractive error in patients with refractive accommodative esotropia. METHODS: We retrospectively reviewed the medical records of 54 patients with accommodative esotropia who underwent at least 36 months of follow-up and had hyperopia more than +1.50 diopter (D). The patients were divided into groups according to the degree of hyperopia +1.50~ or =+3.00~ or =+5.00 D, the age of their first hyperopic glasses prescription under two-years old, between two to four-years old and older than four years old, whether or not they had amblyopia, the degree of astigmatism or =0.75- or =1.25 D and divided into two groups according to the degree of stereopsis 400 sec. The divided groups were than retrospectively reviewed if they influenced the refractive error at the third year of follow-up using Fisher's exact test, paired t-test, Wilcoxon's signed-ranks test, Mann-Whitney U test, Kruskal-Wallis H test, and ANOVA (p < 0.05). RESULTS: The mean follow-up period was 103.72 +/- 41.82 months for refractive accommodative esotropia. Patients with a greater initial hyperopic refractive err or showed a significant tendency towards emmetropization with a higher rate of hyperopic decrease (p < 0.001), regardless of the hyperopic refractive error. Statistical differences were not observed in patients who started wearing glasses after four-years old, patients with amblyopia, patients with a large degree of astigmatism, and patients with poor stereoacuity. CONCLUSIONS: Long-term changes of hyperopic refractive error in accommodative esotropia showed a significant decrease when initial hyperopic refractive error was high. Wearing hyperopic glasses at an older age and visual functions such as amblyopia, large degree of astigmatism, and poor stereoacuity may influence emmetropization.