Session: John Lee (Rapid Fire) Poster Session

Clinical characteristics and surgical outcomes in Acute Acquired Commitant Esotropia (AACE)

Noemí ROSELLÓ SILVESTRE^1,2, Alicia GALAN TERRAZA², Sabina LUNA MARINE^1,2

¹University Hospital Santa Creu i Sant Pau in Barcelona, Barcelona, Spain
²clinica Dyto Centro de Estrabismo. , Barcelona, Spain

OBJECTIVE

To analyze the clinical characteristics and surgical outcomes of patients younger than 50 years-old diagnosed with an acute acquired commitant esotropia (AACE) and diplopia

METHODS

A retrospective review of all consecutive patients younger than 50 yo with AACE who underwent bilateral medial rectus recession (BMRR), or monocular medial rectus recession with lateral rectus resection (RR) with a minimum postoperative follow up 6 months. Exclusion criteria included history of strabismus surgery, trauma, or ocular patching. Data included age of onset, visual acuity, refractive error, angle of deviation, interval between onset and surgical correction and postoperative alignment and sensory binocular vision (BV)

RESULTS

Thirty-four patients were included. Twenty-two (64%) were female. The mean refractive error was -1D (-8,75 to +5,25); Sixteen (47%) patients had myopia with a mean of -3,75D (-0.5 to -8.75); 11 (32%) had hyperopia with a mean of +2D (+0,50 to +5,25). Age of onset of deviation was 21,5 (4 to 48) years old. The interval between the onset of diplopia and surgery was 8.7 years (1 to 26). All but 2 patients underwent BMRR. The postoperative follow up was 30.4 months (6 to 93). The mean near deviation improved from 27.1PD (14 to 40) to 4.8PD (0 to 8), and the mean distance deviation improved from 27.6PD (14 to 45) to 6PD (0 to 8) postoperatively. 30 (88%) of the patients had less than 5 PD of near-distance disparity. Postoperatively 32 (94%) of the patients recovered BV. Brain imaging was obtained in 5 patients. No patient had an associated neurological disease.

CONCLUSIONS

AACE in patients under the age of 50 years is more frequent in female and patients with myopia. However, age or degree of refractive error are not associated factors. Our results suggest that associated neurological conditions are uncommon. Our long-term results demonstrate good postoperative alignment, stability and binocularity vision using standard strabismus surgical nomograms.