Long-Term Changes in Refractive Error and Clinical Evaluation in Partially Accommodative Esotropia after Surgery

Area of Science:

• Ophthalmology
• Pediatric Ophthalmology
• Strabismus Surgery

Background:

• Partially accommodative esotropia (PAET) is a common form of childhood strabismus.
• Surgical intervention for the non-accommodative component of PAET is often necessary.
• Understanding refractive error changes post-surgery is crucial for long-term visual outcomes.

Purpose of the Study:

• To investigate refractive error changes after surgery for PAET.
• To analyze the influence of eye dominance and amblyopia on refractive error progression.
• To identify factors associated with discontinuing hyperopic glasses post-surgery.

Main Methods:

• Retrospective study of 68 PAET patients with ≥2 years follow-up after medial rectus recession.
• Analysis of spherical equivalent (SE) refractive error changes.
• Grouping based on eye dominance (dominant, non-dominant, alternative) and amblyopia status (amblyopic, fellow, normal).

Main Results:

• Mean follow-up was 4.89 years; mean SE refractive error change was -0.284 D/year.
• Refractive error change patterns differed significantly between amblyopic, fellow, and normal eyes (p=0.0002).
• Patients weaned off hyperopic glasses (average age 9.41 years) had significantly lower SE refractive error (p=0.0002).

Conclusions:

• Amblyopia is associated with altered refractive error changes post-PAET surgery.
• Successful discontinuation of hyperopic glasses is linked to lower refractive error and specific clinical factors.
• Surgical outcomes in PAET require consideration of amblyopia and refractive status.