Surgical outcomes of acute acquired comitant esotropia of adulthood

Dae Hyun Kim,Ha Jeong Noh

doi:10.1186/s12886-020-01793-3

Abstract

BackgroundAcute acquired comitant esotropia (AACE) is a type of strabismus characterized by a sudden onset of large angle esotropia with diplopia, which often occurs in children after infancy, teenagers, and young adolescents. However, studies on the surgical outcomes of only adults are rare. The purpose of this article is to analyze the surgical outcomes for adult patients diagnosed with AACE.MethodsMedical records of 24 patients who had undergone surgery for AACE were retrospectively analyzed. The main outcome measures were the final motor and sensory success rate after surgery and factors affecting motor and sensory outcomes. Motor success was considered alignment within 8 prism diopter (PD) at both near and distance and sensory success was stereoacuity ≥ 60 sec/arc.ResultsThe preoperative mean esodeviation angles were 33.1 ± 10.4 PD at distance and 33.3 ± 11.2 PD at near. The mean period of postoperative follow up was 7.5 ± 4.5 months (range 1–8 months). The postoperative mean esodeviation angles at final follow-up time were 3.4 ± 6.1 PD at distance and 3.8 ± 6.7 PD at near. The surgical motor success rate at final follow-up was 79.2% (19/24). The sensory success rate at final follow-up was 50.0% (12/24). The factor affecting the motor outcome was the type of surgery (p < 0.05). The factor affecting sensory outcome was postoperative follow-up time (p < 0.05).ConclusionsSurgery type appears to affect surgical motor outcomes in adults with AACE. Although the sensory outcome was favorable, it seems that regaining bifoveal fixation takes time.

Highlights

Acute acquired comitant esotropia (AACE) is a type of strabismus characterized by a sudden onset of large angle esotropia with diplopia, which often occurs in children after infancy, teenagers, and young adolescents [1]
AACE of adulthood was diagnosed if esotropia with sudden diplopia developed after 18 years of age and the angle of deviation in near and distance, lateral gaze showed a difference within 5 prism diopters (PD) without limitation of eye movement
Among 24 patients, rectus resection (RR) was done to 18 patients (75.0%) and bilateral medial rectus recession (BMR) was done to 6 patients (25.0%)

Summary

Introduction

Acute acquired comitant esotropia (AACE) is a type of strabismus characterized by a sudden onset of large angle esotropia with diplopia, which often occurs in children after infancy, teenagers, and young adolescents. Studies on the surgical outcomes of only adults are rare. The purpose of this article is to analyze the surgical outcomes for adult patients diagnosed with AACE. Acute acquired comitant esotropia (AACE) is a type of strabismus characterized by a sudden onset of large angle esotropia with diplopia, which often occurs in children after infancy, teenagers, and young adolescents [1]. The intracranial disease including brain tumor had been reported as the cause of some AACE cases; the cause is unclear in most cases [2,3,4]. A recent study reported that the prevalence of AACE is growing as the near work increased due to widespread smartphone possession [5]. Because AACE occurs after the complete development of binocular function, it shows the successful

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