Long-Term Changes in Refractive Error and Clinical Evaluation in Partially Accommodative Esotropia after Surgery.

Abstract

We investigate the changes in refractive error and clinical evaluation in partially accommodative esotropia(PAET) after surgery. A total of 68 patients PAET who received at least 2 years of follow-up after surgery were enrolled in this study. We performed a retrospective study in patients who underwent unilateral or bilateral medial rectus recession for a non-accommodative component of PAET between January 2005 and March 2013. Patients were divided into groups according to the presence of dominancy (dominant, non-dominant, alternative eye), and presence of amblyopia (amblyopic, fellow, normal eye). Changes and changing pattern in SE refractive error were analyzed in all patients and compared between groups. Patients were divided into two groups, those weaned off of hyperopic glasses and those who continued using them, then factors that significantly influenced the continued use of glasses were analyzed. The changes and changing pattern in SE refractive error according to time after operation and presence of amblyopia or dominancy. The mean length of follow-up was 4.89±1.74 years after surgery and the mean change in SE refractive error rate per year was -0.284±0.411 diopters (D). The pattern of changes in the mean SE refractive error for those with dominant, non-dominant, and alternative eyes was not significantly different (p = 0.292). The pattern of changes in the mean SE refractive error for those with amblyopic, fellow, and normal eyes was significantly different (p = 0.0002). Patients were successfully weaned off of hyperopic glasses at an average age of 9.41±2.74 years. The average SE refractive error in the group weaned off of hyperopic glasses was significantly lower than that in the group maintained on hyperopic glasses (p = 0.0002). The change of SE refractive error in amblyopic eyes decreased less than that in fellow or normal eyes, which may be correlated with the presence of amblyopia. Patients with a smaller esodeviated angle without hyperopic correction, a lower degree of hyperopia, and who were older at the time of disease onset were discontinued from hyperopic glasses sooner after surgery.