Adult-Acquired Esotropia: Clinical Characteristics, Risk Factors and Outcomes of a Novel Surgical Approach

Objective: We aimed to study acquired esotropia in adults and its risk factors, compile treatments performed and describe surgical technique used, with a novel indication. Methods: We conducted a retrospective study of patients with insidious distant esotropia along with distant horizontal diplopia (angles 2-30 PD with wide fusion amplitude): Refractively emmetropic, moderately myopic and mildly hyperopic. No systemic alterations. Results: 30 cases were included, average age: 38.13 ± 14.95. Mean time elapsed from the onset of symptoms to surgical treatment was 22.52. Mean spherical equivalent is -3.19 ± 2.83. Mean preoperative horizontal deviation was 18.58 ± 5.45 PD in distant vision and 5.48 ± 8.35 PD in close vision (p < 0.001). 100% of cases reported diplopia in distance vision. 20% required prismatic treatment (<10 PD) and 80% surgical (>10 PD) by lateral rectus resection, with an average of 4.82 ± 1.23 mm. Sensory result was successful in 100% of the cases and motor in 75%. Conclusions: We are facing a new type of acquired esotropia in adults that can be individualized by its clinical and therapeutic characteristics. Our prismatic and surgical treatment has been successful.