Characteristics and Surgical Outcomes of Comitant Esotropia in an Adult Population Between 18 and 60 Years Old.

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  • Additional Information
    • Source:
      Publisher: Elsevier Science Country of Publication: United States NLM ID: 0370500 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-1891 (Electronic) Linking ISSN: 00029394 NLM ISO Abbreviation: Am J Ophthalmol Subsets: MEDLINE
    • Publication Information:
      Publication: 1999- : New York, NY : Elsevier Science
      Original Publication: [Chicago, etc., Ophthalmic Pub. Co., etc.]
    • Subject Terms:
      Esotropia*/surgery ; Esotropia*/physiopathology ; Ophthalmologic Surgical Procedures* ; Oculomotor Muscles*/surgery ; Oculomotor Muscles*/physiopathology ; Vision, Binocular*/physiology ; Visual Acuity*/physiology; Humans ; Female ; Retrospective Studies ; Male ; Adult ; Middle Aged ; Adolescent ; Young Adult ; Treatment Outcome ; Eye Movements/physiology ; Accommodation, Ocular/physiology
    • Abstract:
      Purpose: To describe the clinical characteristics and surgical outcomes of adults with comitant nonaccommodative esotropia.
      Design: Retrospective case series.
      Methods: Retrospective review of medical records of patients 18 to 60 years old with comitant esotropia who underwent strabismus surgery at a tertiary eye care center between 2014 and 2023. The etiology of esotropia was categorized into three groups based on the disparity between near-distance angles of deviation: (1) basic esotropia (ETBA); (2) esotropia divergence insufficiency pattern; or (3) esotropia convergence excess pattern. The main outcome measures were strabismus characteristics and motor and sensory surgical outcomes. Surgical motor success was defined as a deviation that measured ≤10 prism diopters (PD).
      Results: Of the 219 that met the inclusion criteria, most patients were female (140, 64%) and had a mean age of 36.7 ± 12.3 years (range 18-60 years). The majority were myopic (157, 72%) and reported diplopia (176/219, 80.3%). The esotropia convergence excess pattern group had the largest mean deviations at both distance (45.5 ± 11.5 PD) and near (64 ± 12.3 PD) while the ETBA group had the largest ranges at distance (31 ± 13.5 PD, range 3-90) and near (30 ± 15 PD, range 2-85). Bilateral medial rectus recession and unilateral recess-resect procedures were performed with equal frequency (both 48%). Motor and sensory success were achieved more often with recess-resect than bilateral medial rectus recession, although only motor success was statistically significant (87.8% vs. 73.2%, P = .0375 and 93.3% vs. 85.5%, P = 15, respectively). At the last encounter, 88.1% (119/135) of patients with preoperative diplopia achieved single binocular vision.
      Conclusions: Regardless of the pattern of esotropia, strabismus surgery in adults with comitant nonaccommodative esotropia resulted in good motor and sensory outcomes.
      (Copyright © 2024 Elsevier Inc. All rights reserved.)
    • Publication Date:
      Date Created: 20240616 Date Completed: 20241017 Latest Revision: 20241017
    • Publication Date:
      20241017
    • Accession Number:
      10.1016/j.ajo.2024.06.012
    • Accession Number:
      38880372