Purpose: To investigate the surgical outcomes and prognostic factors in patients with partially accommodative esotropia.
Methods: Forty-two patients (age, 5.9±2.7 years [mean±standard deviation]) who were administered preoperative Fresnel membrane prism treatment (classic prism adaptation test [PAT] ) or PAT at the time of consultation were retrospectively investigated. The target angle for the surgical correction was determined using the prism-adapted angle (PAT angle) and augmented angle (the average of distance deviation angle with correction and near deviation angle without correction). Surgical success was defined as having the eye position of±8 prism diopters (PD) or heterophoria at distance and near after postoperatsive 6-12 months. The following factors associated with surgical outcomes were investigated: age of onset, age at surgery, refraction, pre- and postoperative angles of deviation, PAT angles, increased angles (differences in pre- and post-PAT), target angles, and pre- and postoperative binocular visual functions.
Results: The preoperative angle of deviation was 31.2±10.8 PD at distance and 36.9±11.4 PD at near, whereas the postoperative angle of deviation was 4.2±8.5 PD at distance and 5.1±8.9 PD at near. Significant differences were observed in the following factors between the success (32 patients) and failure (10 patients) groups: age of onset (32±15 months vs. 18±12 months, p=0.01), the preoperative angles of deviation at distance (29.5±10.1 PD vs. 37.7±10.9 PD, p=0.03) and near (34.3±9.6 PD vs. 45.0±13.5 PD, p=0.008), and PAT angles (34.0±9.4 PD vs. 44.7±9.0 PD, p=0.003). Postoperative stereoacuity was measured in 39 patients, among which 27 were in the good group having stereoacuity of 3,000 seconds or better and 12 were in the nil stereoacuity group having no stereopsis. The age at onset was significantly higher in the good group than in the nil stereoacuity group (p=0.002).
Conclusion: In the short-term postoperative follow-up, good surgical outcomes were found to be associated with older age of onset and smaller preoperative angles, and good postoperative stereoacuity was associated with older age of onset.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 127: 680-688,2023.