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[Acute Acquired Comitant Esotropia Type 2 - A Retrospective Analysis].

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Acute acquired comitant esotropia (AACE) Type 2 in children presents with mild hyperopia and large esotropia. Early strabismus surgery offers an excellent prognosis for stereopsis recovery, even with preoperative amblyopia.

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Area of Science:

  • Ophthalmology
  • Pediatric Ophthalmology
  • Strabismus Research

Background:

  • Acute acquired comitant esotropia (AACE) Type 2 is a rare childhood strabismus.
  • Key features include acute onset around age 3, large comitant angle, no accommodative component, mild hyperopia (≤3D), and measurable stereopsis.
  • Urgent strabismus surgery is crucial to prevent stereopsis maldevelopment or loss.

Purpose of the Study:

  • To describe the clinical characteristics of AACE Type 2.
  • To evaluate the outcomes of strabismus surgery in affected children.
  • To assess the role of preoperative factors like amblyopia on prognosis.

Main Methods:

  • Retrospective analysis of 18 patients with suspected AACE Type 2 undergoing strabismus surgery (Oct 2011 - Sep 2019).
  • Data collected included age, symptoms, visual acuity, refractive status, surgical details, and ocular alignment/stereopsis pre- and post-surgery.
  • Ethical approval obtained from the Cantonal Ethics Committee of Zurich.

Main Results:

  • 18 patients (12 male, 6 female) with mean hyperopia of 1.4±0.6D were analyzed.
  • Surgery occurred between 2.0-11.1 years of age, within 6 months of symptom onset in 12/18.
  • Preoperative strabismus angle (38±10 PD) significantly reduced post-surgery (3±3 PD at 3 months, 2±2 PD at 12 months); stereopsis recovered in all patients by 12 months.

Conclusions:

  • AACE Type 2 is characterized by mild hyperopia and large, non-accommodative esotropia.
  • Prognosis for stereopsis recovery following timely surgery is excellent.
  • Preoperative amblyopia does not preclude a diagnosis of AACE Type 2, emphasizing the need for prompt intervention.