Session: Poster session A

Effect of Distance-Near Incomitance at Esotropia Surgery

Pinar BINGÖL KIZILTUNÇ¹, Sultan Begüm F?RAT¹, Huban ATILLA¹

¹Ankara University, School of Medicine, Department of Ophthalmology, Ankara, Turkey

Introduction: To evaluate the effect of distance-near incomitance on surgical success, stereopsis and development of consecutive exotropia in patients with esotropia (ET) surgery.

Methods: Records of patients who had ET surgery were evaluated. Patients with similar distance and near deviation were grouped as group 1, patients with more than 10 prism diopter (PD) difference between distance and near deviation were grouped as group 2. Preoperative and postoperative refractive errors, distance and near deviations, binocularity, postoperative surgical success and improvement of binocularity were evaluated. Surgery was planned according to the amount of near deviation.

Results: There were 43 patients in group 1 and 16 patients in group 2. There was a statistically significant difference between groups in terms of distance deviation (Group 1: 39.23 PD, group 2: 27.56 PD) but not for near deviation (42.78 PD / 44.38 PD respectively). Mean spherical equivalent was statistically significantly higher in group 2 (Group 1: 1.38 D, group 2: 2.52 D). There was no difference for binocularity with W4D and stereopsis levels preoperatively. In the postoperative period, the distance and near deviation amounts were found to decrease significantly in both groups in comparison to the preoperative period and the surgical success rate was 65.1% for group 1 and 62.5% for group 2. However development of consecutive XT was higher in group 2 (Group 1: 11.6%, group 2: 25%). Improvement of fusion and stereopsis were found to be better in group 1.

Conclusions: Surgical success rates were similar in both groups regardless of the distance-near incomitance. However consecutive exotropia was higher in patients with distance-near incomitance and fusion and stereopsis were better in group 1. The amount of near deviation is accepted as having more importance in surgical decision however in cases with distance-near incomitance AC/A ratio should be considered and surgical numbers must be revised.