The Surgical Outcome of Partially Accommodative Esotropia with a Large Angle of Deviation

ABSTRACT

PURPOSE: To investigate the surgical outcome of patients with partially accommodative esotropia with a large angle of deviation. METHODS: Twenty-one patients with partially accommodative esotropia that had angles of deviation of at least 40 prism diopters without correction, were retrospectively studied. They underwent standard surgery, for which the amount of recession was based on the average of the distance and near deviation with correction. The angle of deviation were evaluated at postoperative 3 months and at the last follow-up, and the Titmus test and Worth 4-dot test were performed after surgery. RESULTS: The mean angle of deviation without correction at the first examination was 57.0PD, and the mean age of correction with glasses was 2.6 years. The mean angle of deviation with correction was 31.4PD. The mean age at surgery was 4.4 years. The mean follow-up period was 5.4 years. At 3 months postoperatively, 66.7%, 28.6%, and 4.8% of patients showed acceptable correction, undercorrection, and overcorrection, respectively. At the last visit, undercorrection decreased while overcorrection increased (66.7%, 23.8%, 9.5%). Titmus stereotest showed in positive results with more than 800 seconds of arc in 9 of 16 patients. A Worth 4-dot test resulted in a fusion response at far or at near in 4 of 17 patients. CONCLUSIONS: In partially accommodative esotropia with a large angle of deviation (at least 40PD without correction), the results of conventional surgery were relatively fair, while the prognosis of sensory function was poor.