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Yu Huan-yun; Adjustable suture procedure for the acute concomitant esotropia. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2587.
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© ARVO (1962-2015); The Authors (2016-present)
Most of the development of acute concomitant strabismus occurr after the establishment of binocular vision, and often observed in those who had potential to restore binocular vision. This study focuses on the role of adjustable suture (AS) strabismus surgery in the treatment for acute concomitant esotropia (ACE).
Twenty-four patients underwent medial rectus adjustable suture recession surgery or combined with lateral rectus resection surgery. We adjusted the suture intraoperatively for adults or elder children, and 1 day postoperatively for the younger children ( less than 10 years old). Angle of deviation and bilocular vision were measured pre- and postoperetively. The period for follow-up was at least 6 months (range from 6 months to 6 years).
Among the 24 patients, 6 patients were young children who were less than 10 years old (age range of 4 to 9 years old), and the other 18 patients were older than 16 years (age range of 16 to 41 years old). The mean angle of deviation was +46.9 ±26.7 prism diopters (range of 25-80 prism diopters). The stereoscopic vision of all patients had been destructed preoperatively. Twelve patients needed to be adjusted intra- or postoperatively. After surgery, all patients were orthophoric or minimally esophoric, and in all of them stereoacuity (measured by the random dot stereograms) was less than 120 arc seconds.
Proper ocular alignment postoperatively is essential for restoring bilocular vision in those with acute concomitant esotropia. We believe that the adjustable suture may assist in achieving this goal.
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