Strabismus Surgery for Elimination of Bifocals in Accommodative Esotropia

Gregg T. Lueder, Alan A. Norman

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

Purpose: This study reports the outcomes of strabismus surgery to eliminate bifocals in patients with accommodative esotropia with a high accommodative convergence to accommodation (AC:A) ratio. Design: Retrospective interventional case series. Methods: Sixteen patients who wore bifocals for treatment of accommodative esotropia with a high AC:A ratio underwent strabismus surgery following prism adaptation testing (PAT) for the near angle of esotropia without bifocals. Outcomes were considered successful if patients had microtropias and maintained fusion without bifocals. Results: All patients had successful outcomes after one or two surgeries. Three of 13 (23%) patients with positive PATs required two surgeries. Two of three (67%) patients with negative PATs required two surgeries. Binocularity remained the same in 13 patients and improved in three patients. Glasses were eliminated entirely in eight of 16 (50%) patients. Conclusions: Strabismus surgery may eliminate the need for bifocal glasses in patients with accommodative esotropia with a high AC:A ratio, with many patients able to discontinue glasses entirely. Preoperative PAT may help predict the risk of requiring more than one surgery.

Original languageEnglish
Pages (from-to)632-635
Number of pages4
JournalAmerican journal of ophthalmology
Volume142
Issue number4
DOIs
StatePublished - Oct 2006

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