Surgical outcomes for esotropia in children with high accommodative convergence/accommodation ratio


To assess whether a high accommodative / accommodative convergence (AC / A) ratio affects surgical outcomes in children with esotropia (ET) and to assess the appropriate target angle of surgical dosing in the presence of a high AC / A ratio. A retrospective review identified patients who suffered a primary bilateral medial rectus (BMR) due to TS. Patients were excluded if the follow-up was ≤ 2 months. Basic demographic information, visual acuity, stereopsy, orientation, and target angles for surgery were collected. High AC / A was defined as a deviation of ≥10 prismatic diopters (Δ)  near compared to distance. Outcome parameters were near and far deviations ≤10Δ within orthophoria and / or postoperative stereopsis. Yates' Continuity Correction, Unpaired T Test, Regression Analysis and one-way ANOVA were used. 103 patients were identified preoperatively, 23 with high AC / A and 80 with normal AC / A. The mean age was 4.0 ± 2.5 years. Surgical success, measured by postoperative orientation, was 48% and 45% in the high AC / A and normal AC / A groups (P = 1.0). There was a statistically significant difference in preoperative close deviation between the high AC / A and normal AC / A groups (P = 0.0015); however, there were no significant differences in preoperative distance deviation (P = 0.061). Furthermore, there were no significant differences in preoperative or postoperative stereopsis between the high AC / A and normal AC / A groups (P = 0.88 and P = 0.44, respectively). There was a significant difference in the normal AC / A and high AC / A groups when the target angle was in the preoperative near deviation as determined by one-way ANOVA (F = 170.88, P <0.0001, and P <0, 0001, respectively). F = 14.61, P = 0.0010). In ET treated with BMR recession, the presence of a high AC / A does not affect surgical success as measured by alignment and stereopsis. Furthermore, at high AC / A values, surgical dosing with a target angle in the direction of a close deviation has been found to provide the best surgical results in our patient population. 

Comments

Post a Comment

Popular posts from this blog

Longitudinal Changes in Scotopic and Mesopic Macular Function as Assessed with Microperimetry in Patients with Stargardt Disease

Image
  The Nidek MP1S device was used to measure central 20 ° macular sensitivity under mesopic and scotopic conditions. Mean deviations (MD) from normal value for mesopic macular sensitivity for fovea (within 2 ° eccentricity) and extrafovea (4 ° 10 ° eccentricity) and the MD for scotopic sensitivity for extra fovea were calculated. Linear mixed effects models were used to estimate mesopic and scotopic changes and the mMD was 10.7 dB (p <0.001). Longitudinally, all eyes showed a statistically significant deterioration trend: the rates of foveal mMD and extrafoveal mMD and some were 0.72 (95% CI 0.37 to 1.07), 0.86 (95% CI: 0.58 to 1.14) and 1.12 (95% CI.). : 0.66 to 1.57) dB / year. In STGD1, the loss of scotopic macular function preceded the extrafovea and was faster than the loss of mesopic macular function. Scotopic and mesopic macular sensitivities using microperimetry provide alternative visual function results for STGD1 treatment studies. At baseline, all eyes had a larger sMD...
Read more

A Revision of the International Classification of Retinopathy of Prematurity

Image
Retinopathy of prematurity (ROP) is still a major threat to premature babies' vision, with some cases resulting in irreversible vision loss. The International Categorization of Retinopathy of Prematurity (ICROP), a clinical classification system for acute ROP, was created in 1984 with input from experts from around the world.  Cryotherapy's efficacy in preventing retinal detachment and vision loss due to ROP was promptly proven in a multicenter clinical trial. 2 Since its inception, ICROP has enhanced clinical care by permitting reliable documenting of ROP, facilitating comparison of serial examinations by numerous doctors, and facilitating consultation with peers. The ICROP has undergone fine-tuning in the past, most recently in 2005. 3 The ICROP3 classification, which was released this year, was updated to better characterise the disease as it is being managed. 4 ICROP3's primary revisions address concepts added over the last two decades that are thought to influence the ...
Read more

Independent and integrated ophthalmology – where justice and excellence meet

Image
About 2.2 billion people worldwide are visually impaired, at least half of whom are preventable. Current estimates of preventable causes of moderate to severe visual impairment or blindness include untreated refractive error (88.4 million), cataracts (94 million), glaucoma (7.7 million), corneal opacity (4.2 million), Includes diabetic glaucoma (3.9 million) and trachoma (3.9 million). 2 million), but mostly due to uncorrected presbyopia (826 million). Of gross domestic product.  The World Health Organization's resolution on "Integrated Human-Centered Ophthalmology (IPEC), Including Preventive Blindness and Visual Impairment". At the core of the resolution is to make IPEC the optimal model and ensure its widespread implementation. It is estimated that about two-thirds of the population of India may require free or subsidized eye care, and if they have no such access, they may suffer marginalization and exclusion. Affordable and accessible high-quality care delivered by t...
Read more