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Related Experiment Video

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Author Spotlight: Advancements in Refractive Surgical Correction for Presbyopia and Exploring Postoperative Visual Acuity
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Surgical Outcomes in Partially Accommodative Esotropia Using Augmented Distance-Angle Averaging With and Without

Veronika Yehezkeli1, Emanuil Parunakian2, Qingyu Meng3

  • 1From the Stein Eye Institute and Department of Ophthalmology (V.Y., Q.M., J.L.D., S.Y.S.), University of California, Los Angeles, California, USA.

American Journal of Ophthalmology
|April 4, 2026
PubMed
Summary

Augmented medial rectus recession for partially accommodative esotropia (PAET) shows good outcomes, but 30% of patients still have residual esotropia. Even augmented dosing may be insufficient for some PAET cases.

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Area of Science:

  • Ophthalmology
  • Strabismus Surgery
  • Pediatric Ophthalmology

Background:

  • Medial rectus (MR) recession is a standard treatment for partially accommodative esotropia (PAET).
  • Undercorrection is a frequent complication following standard MR recession in PAET patients.

Purpose of the Study:

  • To evaluate the motor and sensory outcomes of augmented MR recession in patients diagnosed with PAET.
  • To assess the efficacy of an augmented surgical approach in managing partially accommodative esotropia.

Main Methods:

  • An interventional case series was conducted involving patients with PAET.
  • Patients underwent augmented bilateral MR recession, with surgical targets based on average distance esotropia (with and without hyperopic correction).
  • Posterior pulley fixation was utilized in a subset of patients to address distance-near disparity.

Main Results:

  • 110 PAET patients (mean age 5±3 years) were included. Preoperative esotropia averaged 42±13Δ (uncorrected) and 25±11Δ (with correction).
  • Despite augmented dosing, 30% of patients had residual esotropia (>5Δ) at follow-up. Consecutive exotropia occurred in 8% of patients.
  • Posterior pulley fixation reduced distance-near disparity from 12±5Δ to 1±4Δ. Reoperation was needed in only 7% of cases.

Conclusions:

  • Augmented bimedial rectus recession for PAET yields favorable motor and sensory outcomes.
  • A significant portion (30%) of patients experienced residual esotropia, indicating augmented dosing may still be insufficient.
  • Overcorrections were rare and managed effectively with reduced hyperopic spectacle power.