Diagnoses and surgical outcomes of acute acquired comitant esotropia associated with myopia

Jiang Lin


Purpose: To investigate the diagnoses and surgical outcomes of acute acquired comitant esotropia (ACCE) with similar symptoms who were associated with myopia. Methods: The data of the 84 cases, who received treatments for esotropia in the Aier eye hospital between February 2014 and February 2019, were collected. The age of them was 12ï½?18 years, and 44 patients were male. Preoperatively, patients complained diplopia. All they were homonymous diplopia and no difference in different diagnostic eye positions; Eye movements were normal; Prism test was +15ï½?+45 prism diopters(PD); The angle of deviation at distance was more than 10PD greater than that at near; Cycloplegic refraction was -1.00ï½?-5.00D. No one had neurological diseases. After six months of follow-up, we did the medial rectus (MR) weaken procedure with lateral rectus (LR) strengthen procedure. Results: Diplopia disappeared, and eye positions turned to normal postoperatively. Meanwhile no regressions appeared during six-month reviews. Conclusion: These patients had similar symptoms (e.g. normal eye movements, diplopia especially at distant, etc.). According to these they were diagnosed as ACCE [1]. Besides, they had other same features like low to moderate myopia and wearing glasses all the time. Therefore, ACCE associated with myopia could be a better diagnosis. The onset of this disease related to near-work directly leads to convergence excess and divergence insufficiency. Apparently, visual training is not a preferred treatment of divergence insufficiency, and surgery for this kind of esotropia would be better. Compared with other doctors, we rarely use the MR weaken procedure only. Our surgeries mainly strengthen LR with slight weakening MR. We just strengthen LR with people less than 15PD at near. By this way, patients with Preoperative diplopia, normal binocular visual function, get pretty surgical outcomes

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