Abstract
Purpose::
To assess the efficacy of prismatic correction for partially accommodative esotropia of 20 prism diopters (PD) or less after a full hypermetropic correction.
Methods::
Medical records of 69 patients (29 males, 40 females) who underwent the prismatic correction for partially accommodative esotropia of 20 PD or less after a full hypermetropic correction were reviewed. The mean age at presentation was 57 ± 46 months and the mean follow up was 6.5 ± 5.6 months. Outcomes were considered successful if patients maintained orthotropia or esophoria without surgery for at least 3 months and showed no deterioration of binocular sensory function. Factors including age, sex, best corrected visual acuity (BCVA), refractory errors, ocular alignment, and binocular sensory function were analyzed and compared.
Results::
The success rate was 41% (28 of 69 patients). The pre-treatment angle of esotropia was significantly lower in the success group both at distance and at near (p=0.000). The success group showed a better response with Worth 4 dot test and Randot stereotest before the prismastic correction. The patients with pre-treatment angle of esotropia ≤ 10 PD showed a significantly higher success rate than those > 10 PD. There was no significant difference in age, sex, BCVA, or refractory errors between the success group and failure group.
Conclusions::
Prismatic correction was successful in 41% of the patients with partially accommodative esotropia ≤ 20 PD. The success rate was higher as the patient has smaller angle of esotropia and better fusion and stereopsis before the prismastic correction.
Keywords: strabismus: treatment • esotropia and exotropia • binocular vision/stereopsis