Clinical observation of surgical outcomes of patients with Bielschowsky type acute acquired concomitant esotropi

Jiwen Yang


Purpose: To review and analyze surgical outcomes of patients with Bielschowsky type acute acquired concomitant esotropia (AACE).   Methods: Retrospective study. We enrolled 9 esotropia and diplopia patients with myopia who performed strabismus surgery in Shenyang Aier Eye Hospital between June 2018 and March 2019, including 4 males, 5 females. The mean age of the patients was 22.67±5.41 (range, 16-30) years. They underwent monocular Medial Rectus Recession and Lateral Rectus Resection (6 cases), monocular Lateral Rectus Resection (3 cases).   Results: 1.The mean time of esotropia and diplopia onset: 22±15.59 (range, 6-48) months. 2. Incentives and treatment history: Excessive near working (2 cases), acupuncture treatment (3 cases), others with no treatment.3.The mean refractive errors in the right and left eyes were -4.05±1.34 (range,-2.25~-6.50) and -3.52±0.98 (range,-2.00~-5.25) diopters (D), respectively. 4. The mean AC/A value: 2.04±1.10 (range,0.67~4).5.Esodeviations: Average preoperative esodeviations at near and distance were 22.67±12.41(range,14~48) and 29.11±9.27(range,18~46) PD, average postoperative esodeviations at near and distance were 0 and 0.44±1.33(range,0~4)PD. There were significant statistically difference between preoperative and postoperative esodeviations both at near (T=5.48ï¼?Pï¼?0.01) and distance (T=8.65ï¼?Pï¼?0.0 1), respectively.6.The mean Medial Rectus Recession 2.44±1.94 (range,0-5) mm, 3 cases had dominant diplopia at distance, so they underwent monocular Lateral Rectus Resection, the mean Lateral Rectus Resection 4. 89±0.78 (range,4-6) mm.7.Diplopia: 9 patients all had diplopia preoperatively, all disappeared postoperatively. 8. Stereopsis: 5 patients had no stereopsis before surgery, 3 cases regained stereopsis after surgery.   Conclusions: In case of patients with Bielschowsky type AACE, surgery is the main treatment, patients achieved successful surgical alignment and the diplopia vanished as well. For patients with myopia, they should control the near work moderately

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