Long-term motor and sensory outcomes after surgery for the nonaccommodative component of partially refractive accommodative esotropia.

PURPOSE: To report long-term motor and sensory outcomes after surgery for the nonaccommodative component of partially refractive accommodative esotropia (PRAET).

METHODS: The medical records of consecutive patients ≤11 years old operated for the nonaccommodative component of PRAET and followed postoperatively for at least 10 years were retrospectively reviewed.

RESULTS: A total of 47 patients were included (median age, 3.0 years). The mean postoperative follow-up was 12.15 ± 2.05 years (range, 10.00-17.50 years). Overall, 23 patients (49%) had surgical success; 10 (21%), decompensation; and 7 (15%), esotropia with a high ratio of accommodative convergence to accommodation (AC/A) or consecutive exotropia. The median age at surgery, mean cycloplegic refraction, median near and distance deviation, presence of binocular vision, and amblyopia did not predict decompensation, a high AC/A ratio esotropia, and consecutive exotropia. Eight patients (18%) achieved stereopsis. Patients with an older age at onset (2.87 ± 1.31 years) and a shorter duration of strabismus (≤4 years) achieved better stereopsis.

CONCLUSIONS: Nearly half of our patients with PRAET achieved a successful ocular alignment after surgery for the nonaccommodative component. Some developed decompensation, a high AC/A ratio esotropia, or consecutive exotropia. Few patients achieved stereopsis. Older age at onset and a shorter duration of strabismus predicted a better stereopsis outcome.