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Clinical characteristics and surgical outcomes of adults with acute acquired comitant esotropia

Japanese Journal of Ophthalmology volume 63, pages 483–489 (2019)Cite this article

Abstract

Purpose

To investigate clinical characteristics of adults with acute acquired comitant esotropia and to evaluate the muscle recession amount needed to achieve a favorable outcome after performing medial rectus muscle recession.

Study designs

Retrospective study.

Methods

Patients diagnosed with acute acquired comitant esotropia, who underwent medial rectus muscle recession with adjustable suture between 2008 and 2016 were included. Surgical outcomes were classified into motor and sensory. The motor outcomes were evaluated at the 1-year postoperative visit and divided into success (orthotropia or esodeviation ≤ 8 PD) and failure (esodeviation > 8 PD). The successful sensory outcomes were defined as elimination of diplopia in primary gaze. Factors including age, sex, refractive error, deviation angle, and surgical amount were compared between groups.

Results

Sixteen subjects were included whose mean (± SD) age at the initial visit was 27.5 ± 11.0 years. Mean preoperative maximum angle of deviation was 27.9 ± 9.3 PD at distance and 28.6 ± 12.0 PD at near. Mean refractive error was -2.55 ± 2.92 D. Twelve of 16 subjects (75%) had successful motor and sensory outcomes. Age, sex, refractive error and deviation angle were not different between the two groups. Both success and failure groups required a greater amount of medial rectus muscle recession than those indicated by the Parks’ surgical table, with a 40.6 ± 25.8 % augmentation in the success and 7.9 ± 6.9 % in the failure group (P = .028).

Conclusions

To achieve better surgical outcomes in adults with acute acquired comitant esotropia, targeting postoperative orthotropia by increasing the amount of medial rectus muscle recession is recommended.

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Fig. 1

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Acknowledgements

This work was supported by the National Research Foundation of Korea (NRF) Grant funded by the Korean Government (MOE) (No. 2017R1D1A1B03032985).

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Affiliations

  1. Department of Ophthalmology, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul, 110-744, Republic of Korea

    Haeng-Jin Lee & Seong-Joon Kim

  2. Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul, Republic of Korea

    Seong-Joon Kim

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  1. Haeng-Jin Lee
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Correspondence to Seong-Joon Kim.

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H. J. Lee, None; S. J. Kim, Grant (National Research Foundation of Korea).

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Corresponding Author: Seong-Joon Kim

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Lee, HJ., Kim, SJ. Clinical characteristics and surgical outcomes of adults with acute acquired comitant esotropia. Jpn J Ophthalmol 63, 483–489 (2019). https://doi.org/10.1007/s10384-019-00688-1

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  • DOI: https://doi.org/10.1007/s10384-019-00688-1

Keywords

  • Acute acquired comitant esotropia
  • Adult esotropia
  • Medial rectus recession