Strabismus Surgery for Patients With Acquired Nonaccommodative Esotropia Based on Monocular Occlusion Test Publisher Pubmed



Masoomian B¹ ; Othman N¹ ; Mirmohammadsadeghi A¹ ; Akbari MR¹ ; Khorraminejad M^{2, 3} ; Sadeghi M¹
Source: Journal of AAPOS Published:2024

Abstract

Purpose: To evaluate the outcome of surgery based on a monocular occlusion test in patients with acquired nonaccommodative esotropia (ANAET). Methods: Patients with ANAET in which the angle of esodeviation increased by at least 10Δ after 1 hour of monocular patching were enrolled prospectively. Results: A monocular occlusion test was performed for 32 patients, of whom 14 patients showed significant change in the angle of esotropia. The mean age was 21.4 (range, 5-50) years, and 8 (57%) were females. The mean spherical equivalent was 0.24 D for right eyes and 0.35 D for left eyes. The mean angle of esotropia before occlusion was 9.9Δ ± 6.4Δ (range, 2Δ-20Δ) for distance and 13.8Δ ± 6.6Δ (range, 4.5Δ-25Δ) for near. The mean angle of esotropia after monocular occlusion was 22.3Δ ± 5.1Δ (range, 12Δ-30Δ) for distance and 24.6Δ ± 6.2Δ (range, 12Δ-32.5Δ) for near. Bimedial rectus muscle recession was performed for all the patients according to near esotropia after 1 hour of monocular occlusion. Patients were followed for 12 months. Final mean angle of esodeviation was 1.0Δ ± 2.2Δ (range, 0Δ-6Δ) for distance and 3.6Δ ± 3.2Δ (range, 0Δ-10Δ) for near. But for a single case, patients achieved alignment <8Δ of esodeviation after surgery. There was no report of diplopia or other complications postoperatively. Conclusions: The findings advocate incorporating monocular occlusion into the preoperative assessment to determine the surgical target in ANAET patients. © 2024 American Association for Pediatric Ophthalmology and Strabismus