Accomodative Esotropia: Clinical Features, Treatment Results And Effect of Treatment on Binocularity

Abstract

Objective: To evaluate clinical features and treatment results in patients who have accomodative esotropia, and to discuss the effect of refractive and/or surgical correction on the development of binocularity. Material and Methods: The clinical and demographic features of 161 patients who had the diagnosis of accomodative esotropia, and who had been followed for at least 6 months in Hacettepe University Department of Ophthalmology Pediatric Ophthalmology and Strabismus Section between 1990-2011 were reviewed. The amount of near and far esodeviations, fusion, stereopsis, surgical and refractive corrections were evaluated at the initial and final visits. Results: Eighty-five (52.79%) boys with median age of 4 years (1-24), and 76(47.20%) girls with median age of 5 years (1-16) were enrolled in the study. The median follow-up was 26 months (6-133 months). Of 161 patients, 125 (77.64%) had partial accomodative, and 36 (22.36%) had full accomodative esotropia. Fifty-five patients (34,16 %) underwent surgery during follow-up. The recession of bilateral medial recti was the most common surgical procedure (30 patients, 54.54%), followed by unilateral recession-resection procedure (23 patients, 41.81%). The amount of hyperopia, and near and far esodeviations measured at the final visit were statistically lower compared to initial visit (p<0.05). Forty-two patients (26.08%) had fusion, 57 (35.41%) patients had stereopsis in different levels at the final visit. Conclusion: Appropriate measurement of refractive errors and full correction of hyperopia are essential for the treatment of accomodative esotropia. The refractive and surgical correction was found to have similar effect on the development of binocularity on long term follow-up.