Long-term Follow-up Results of Partially Accommodative Esotropia After Near Geared Standard Surgery

ABSTRACT

PURPOSE: To analyze the long-term outcome of near geared standard surgery with full hyperopic correction for partially accommodative esotropia. METHODS: The medical records of a total of 24 patients with partially accommodative esotorpia, who had undergone bilateral or unilateral medial rectus recession were retrospectively reviewed. The amount of medial rectus recession was measured based on the near deviation after full hyperopic correction. During the follow-up period the changes of refractive error and angle of deviation were evaluated, and the titmus test and Worth 4-Dot test were performed. RESULTS: The mean ages were 36.63+/-13.38 months (14~59 months) at the time of wearing glasses and 61.25+/-25.55 months (25~132 months) at the time of operation. The average follow-up period was 59.67+/-32.12 months (18~120 months) and preoperative refractive errors were +3.93+/-1.73 D sph and refractive errors at final visit were +3.64+/-2.07 D sph (P=0.53). The mean amount of esodeviation were 26.08+/-8.13PD and 4.25+/-6.63PD for pre- and post-operatively respectively. Nineteen patients showed postoperative deviation of 10PD or less, one patient was overcorrected, and four patients were undercorrected. Worth 4-Dot test resulted in a fusion response at near and far in one patient preoperatively and in 17 patients postoperatively (P=0.30). A titmus stereotest of less than 100 seconds of arc resulted in 1 of 7 patients and 6 of 14 patients at the time of preoperation and postoperation each (P=0.34). The results were not statistically significant. Four of ten high hyperopic patients (> or = +4.00 diopter) had under- or over-correction (P=0.12), though it was not statistically significant. There were no significant differences in combined conditions. CONCLUSIONS: Near geared standard surgery with full hyperopic correction in partially accommodative esotropia patients gave a good surgical result for patients in the mean follow-up duration of 59.67 months.