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  • Title: Fifteen-year outcome of surgery for the near angle in patients with accommodative esotropia and a high accommodative convergence to accommodation ratio.
    Author: Kushner BJ.
    Journal: Arch Ophthalmol; 2001 Aug; 119(8):1150-3. PubMed ID: 11483081.
    Abstract:
    OBJECTIVE: To determine the 15-year outcome of patients with partly accommodative esotropia with a high accommodative convergence to accommodation (AC/A) ratio who underwent surgery based on the angle of esotropia at one-third meter while wearing full hyperopic correction. METHODS: A retrospective chart review to determine the 15-year outcome of 25 patients whose 6-month outcome had been previously reported as part of a prospective, randomized, masked clinical trial. All patients had partly accommodative esotropia with a high AC/A ratio and underwent surgery based on their esotropia at one-third meter while wearing full-distance optical correction. RESULTS: Fifteen years after surgery, 19 of the 22 patients for whom follow-up data are available had between 0 and less than 10 prism diopters of esotropia. Only 6 of the 19 needed to continue to wear optical correction to maintain satisfactory alignment; however, 8 more needed spectacles for visual purposes. Only 1 patient needed to use a bifocal add to have satisfactory alignment at one-third meter. All patients showed some degree of sensory fusion, with 4 obtaining 40 seconds of stereopsis and another 8 obtaining between 60 and 200 seconds of stereopsis. CONCLUSION: Surgery for the near angle obtained with patients wearing their full hyperopic distance correction provides excellent motor and sensory results in patients with partly accommodative esotropia with a high AC/A ratio.
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