Factors Affecting Outcomes of Stereoacuity in Partially Refractive Accommodative Esotropia with Motor Success Treated by Preoperative Prism Correction and Surgery.

Abstract

Purpose: Favorable stereoacuity does not develop in all patients with partially refractive accommodative esotropia (PRAET) successfully aligned, and there have been few previous reports on the factors influencing stereoacuity outcomes in patients with PRAET treated with prismatic correction (PPC) and/or surgery. This study aimed to analyze factors affecting stereoacuity outcomes in patients of PRAET treated with PPC and surgery.

Study design: Retrospective study.

Methods: Sixty-six patients with alignment within 10 prism diopters at final visit with PPC and surgery were included. According to the final stereoacuity, patients were grouped into the fine group (≤60 arcsec (")), the coarse group (60 "<, 3000" ≤), and absent stereoacuity group. Preoperative patient characteristics were compared among three groups using analysis of variance. Comparison of final stereoacuity among three groups based on age at onset (very early: ≤6 months; early: >6 months, ≤2 years; late: >2 years) was carried out with the Kruskal-Wallis test.

Results: There were no differences in ages at initial PPC, at surgery, at final visit, durations of misalignment, of PPC, or after surgery; however, significant differences in ages at onset and initial visit were found. Age at onset in the absent group was significantly earlier than those of the fine and the coarse groups (p < 0.001 and p < 0.001, respectively). Moreover, of the 25 patients with age at onset >2 years, 18 patients (72%) showed fine or coarse stereoacuity (p < 0.001).

Conclusion: Although stereoacuity outcomes in patients with early onset were poor despite of the finally successful alignments obtained with PPC and surgery, fine stereoacuity and coarse stereoacuity were obtained in 24% and 44% of patients with age at onset >2 years.