Surgical success rates in acquired, comitant, partially accommodative and nonaccommodative esotropia.
Source
Pediatric/Binocular Vision Service, Pennsylvania College of Optometry, Philadelphia 19141.
Abstract
An extensive literature search covering the last 35 years was undertaken to retrieve all English language articles reporting results of surgical management of acquired, comitant, nonaccommodative and partially accommodative esotropia. Thirty-nine studies were found, but only 15 met the minimum criteria which we established for inclusion in our analysis. The functional success rate (some 3-D present) was 15% in 1170 patients, while the overall cosmetic success rate (eyes look straight) was 43% in 1473 patients. Direct comparison to optometric studies is not possible since the criteria for success used in surgical studies are considerably different. The most prevalent complication is the need for reoperation as a result of consecutive exotropia. The data indicate that an end result of consecutive exotropia (eyes float outward) is almost as likely as a functional cure.
(Consecutive exotropia means eyes turn out after surgery when eyes turned in before surgery. From Dr JohnLee, a prominent strabismus surgeon from the UK: “strabismus surgery for esotropia can be overcorrected, wind up with exotropia, and (the patient winds up) between a rock and a hard place with messed-up accommodative-vergence interplay and knowing what to prescribe. Rx lenses earlier, avoid surgery…)