Nonaccommodative Esotropia Research Articles

Early-Onset Accommodative Esotropia

Twenty-one patients had esotropia diagnosed before age 12 months. In all of these patients esotropia was eliminated, at least initially, by antiaccommodative therapy consisting of either full hypermetropic spectacles or miotics, or both. Clinical findings evaluated in these patients were comparable to similar clinical factors studied in a larger series of patients with accommodative esotropia, most with onset after 12 months of age. In approximately 50% of these patients early-onset accommodative esotropia deteriorated to a nonaccommodative esotropia that required surgery despite aggressive antiaccommodative therapy. All but one of the surgically treated patients continued to need hypermetropia spectacles postoperatively to maintain alignment.

Intentional surgical overcorrection of acquired esotropia.

Fifty-eight patients with surgically treated acquired nonaccommodative esotropia were studied retrospectively, to ascertain what immediate surgical result gives the best chance for a postoperative bifoveal fusional result. Of the cases that were initially overcorrected (exodeviations), approximately two thirds were fusing six months or more after surgery. Of the cases that were initially aligned (orthophoric) or undercorrected (esodeviations), only one third were fusing after the same period. These results suggest that intentional surgical overcorrection of cases of acquired nonaccommodative esotropia that have a good fusional potential (ie, equal vision) does appear to be a desirable goal for the immediate postoperative period.