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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 (≥ +4.00 diopter) had under- or overcorrection (p=0.12), though it was not statistically significant. There were no significant differences in combined conditions.
References
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Figure 1.
Preoperative age distribution in patients with partially accommodative esotropia (A, B) and follow-up duration (C). (A) Age at wearing glasses. (B) Age at operation.
Figure 2.
(A) Preoperative and postoperative changes in spherical equivalent. (B) Preoperative angle deviation at near and far. (C) Angle of deviation before and after operation.
Table 1.
Titmus stereoacuity at preoperative and final examination (P=0.34)
| Stereoacuity (seconds of arc) |
No (%) of patients |
|
|---|---|---|
| Preoperative group | Postoperative group | |
| ≤100 seconds | 1 (14.3 %) | 6 (42.86 %) |
| >100 seconds | 6 (85.7 %) | 8 (57.14 %) |
Table 2.
Worth-4 dot test at preoperative and final examination (P=0.30)
| |
No (%) of patients |
|
|---|---|---|
| Preoperative group | Postoperative group | |
| Fusion at near & far | 1 (14.3%) | 17 (77.3%) |
| Diplopia or suppression at near or far | 6 (85.7%) | 5 (22.7%) |
Table 3.
Surgical results for pa surgery (P=0.12) artially accommodative esotropi ia at final follow-up and the effect t of refractive error at the time of
| | Residual ET (N=4) | Success (N=19) | Consecutive XT (N=1) |
|---|---|---|---|
| < +4.0 Diopter | 1 (7.1 %) | 13 (92.9 %) | 0 (0.0 %) |
| ≥ +4.0 Diopter | 3 (30.0%) | 6 (60.0 %) | 1 (10.0 %) |
| Total | 4 (16.6%) | 19 (79.2 %) | 1 (4.2 %) |
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