September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Postoperative analysis of pediatric esotropia associated with high hyperopia
Author Affiliations & Notes
  • Bo Li
    Ophthalmology, Ivey Eye Institute, Western University, London, Ontario, Canada
  • Sapna Sharan
    Ophthalmology, Ivey Eye Institute, Western University, London, Ontario, Canada
  • Footnotes
    Commercial Relationships   Bo Li, None; Sapna Sharan, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 2449. doi:
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      Bo Li, Sapna Sharan; Postoperative analysis of pediatric esotropia associated with high hyperopia. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2449.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To describe clinical features, evaluation, surgical management and outcomes in children with esotropia associated with high hypermetropia.

Methods : Medical records of healthy children who received strabismus surgery at 1 year age or older for accommodative esotropia with hypermetropia larger than spherical equivalence of 4.0 diopters from 2009 to 2015, were retrospectively reviewed. The clinical evaluation, orthoptic assessment, surgical intervention and surgical outcomes were recorded.

Results : A total of 46 patients were identified. The average age was 2.9 years old. The average spherical equivalence of cycloplegic refraction was + 6.0 D. All patients presented with large angle esotropia with glasses correction. Average age of esotropia onset was 1.3 years. Average time between onset of esotropia to glasses correction was 6.9 months. Average duration between glasses use to strabismus surgery was 21.9 months. Post-operatively, 73.9% of patients achieved surgical success with deviation of 10 prism diopters or less from orthotropia, 17.4% of patients had under-correction and 8.7% of patients had over-correction. Overall, 63.0% patients developed binocular single vision. For patients who achieved surgical success, 70.6% developed binocular single vision, compared at 41.7% for patients who were over or under corrected (p = 0.08). For patients who received hyperopic glasses within 6 months of onset of esotropia, 92.3% developed binocular single vision, compared with 59.4% for patients who received hyperopic glasses more than 6 month after the onset of esotropia (p = 0.04). For patients who developed binocular single vision, 60% had received hyperopic glasses within 6 month of esotropia onset. For patients who received surgery within 12 months of receiving hyperopic glasses, 50.0% achieved binocular single vision, compared at 67.8% for patients who received surgery more than 12 month after receiving hyperopic glasses (P=0.36).

Conclusions : Strabismus surgery for accommodative esotropia with high hypermetropia has high rate of surgical success. There is a trend toward higher rate of binocular single vision for patients with surgical success. Shorter time interval between esotropia onset and receiving hyperopic glasses is associated with higher rate of postoperative binocular single vision development. Time between receiving hyperopic glasses and surgery does not influence the rate of binocular single vision development.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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