Accommodative esotropia following surgical correction of congenital esotropia, frequency and characteristics

This study was undertaken to look at the development of accommodative esotropia, which occurs following the surgical correction of congenital esotropia. A retrospective review was done on all congenital esotropia patients operated on by one of the authors from 1974 through mid-1984. The criterion of a minimum of 3 years postsurgical follow-up was met by 101 patients. Of these patients, 52 developed accommodative esotropia, 25 within 3 months of surgery and 27 from 3 to 60 months after surgery. The average preoperative refractive error in the early group was +3.90 and +1.95 in the later group. The average time to develop accommodative esotropia in this group with later onset was 27 months following the initial surgery. It would appear that if the preoperative refractive error is +3.00 or more, and especially if the preoperative deviation responds to spectacles with a reduction of 15 prism diopters or more, then it is very likely that glasses will be required for accommodative esotropia very soon following surgery. There appear to be no clues as to which patients will need glasses later for accommodative esotropia.