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KMID : 1191420090080020051
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Korean Journal of Optometry and Vision Science
2009 Volume.8 No. 2 p.51 ~ p.56
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The Surgical Outcome after Augmented Surgery in Partially Accommodative Esotropia
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Sohn Hee-Jin
Paik Hye-Jung
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Abstract
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Purpose: To investigate the long-term outcome of patients with partially accommodative esotropia who had augmented bilateral medial rectus rectus recession.
Methods: Retrospective review on the medical records of 22 partially accommodative esotropia patients, who had been under follow-up observation for at least one year following augmented bilateral medial rectus recession by one surgeon, has been performed. The amount of medial rectus recession was measured based on the near angle of deviation after full hyperopic correction. The surgical success were evaluated based on the best corrected visual acuity, refractive errors, degree of stereopsis and ocular positions with and without spectacle correction before surgery and final examination.
Results: The mean age of the subjects was 4.7±2.1 years and the average follow-up period was 20.7±8.4 moths. The mean deviation angle of accommodative component was 22.4±8.3 PD, and the one of non- accommodative component was 31.8±8.7 PD. Of the 22 patients, 14 (63.6%) revealed postoperative deviation of less than 10 PD, 3 (13.6%) and 5 (22.7%) exophoria and esophopia more than 11 PD, respectively, 1 day after surgery. 19 (86.4%) showed acceptable deviation at final examination and 3 of 5 who were esophopia at 1 day after surgery remained undercorrected at the final visit. At the last follow-up, best corrected visual acuity of higher than or equal to 0.7 has been found on 29 eyes (76%) out of 38 eyes of 19 patients, and binocular amblyopia and monocular amblyopia have been found on total of 6 patients, 3 patients of each. Out of 13 patients without amblyopia, 12 patients showed acceptable deviation. Titmus stereotest resulted in positive fly (3,000 sec of arc) in all 14 patients and more than 100 sec of arc in 8 patients.
Conclusions: Surgical outcome in patients with partially accommodative esotropia who had augmented surgery based on the near angle of deviation had very satisfied. Augmented surgery provides some degrees of stereoacuity and fusion, and further management of ambyopia is important for better long-term results.
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KEYWORD
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Augmented, Near deviation, Partially accommodative esotropia
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