Surgical correction of esophorias

Abstract

A report covering 80 cases of esophoria in which surgery was performed. All the patients had previously suffered from severe headache and other complaints. Preoperative treatment consisted of full prismatic correction. The power of the prisms was measured by the "Polatest" method. We observed that the increase of the angle was initially very slow; sometimes two years or more were needed for it to reach 15 degrees. Subsequently the angle increased rapidly, stabilizing a few months later, whereupon surgery was performed. The peroperative angle varied from 15 degrees to 56 degrees. Postoperatively most cases attained orthophoria, some others a residual esophoria; there were only three cases of exophoria, these being among the 14 cases who had to undergo surgery twice. Sixty percent of the patients were subsequently free of complaints and the rest, with two exceptions, showed a distinct improvement. The average follow-up period was 2.2 years after surgery. One may conclude that esophorias which give rise to complaints can be treated with prisms, but that some of them may have to be operated on. For successful treatment a reliable instrument for measuring the angle of the phoria is indispensable. We found the Polatest best for this purpose. In most cases orthophoria and permanent relief of symptoms will result.