ROC-based validation of an 8-prism diopter surgical target angle in comitant esotropia

Area of Science:

• Ophthalmology
• Pediatric Ophthalmology
• Strabismus Surgery

Background:

• Comitant esotropia is a common childhood eye misalignment.
• Simultaneous perception is the foundational level of binocular vision.
• Surgical outcomes in pediatric strabismus require objective measures.

Purpose of the Study:

• To determine the optimal postoperative ocular alignment for achieving simultaneous perception in pediatric comitant esotropia.
• To evaluate the utility of receiver operating characteristic (ROC) analysis in defining ideal alignment thresholds for binocular cooperation.

Main Methods:

• Retrospective analysis of pediatric patients with comitant esotropia who underwent strabismus surgery.
• Application of ROC curve analysis to postoperative alignment data.
• Identification of alignment ranges predictive of simultaneous perception.

Main Results:

• Out of 99 patients, 87 had surgical correction.
• Postoperative alignment within 8 prism diopters (PD) was significantly associated with simultaneous perception.
• ROC analysis demonstrated high sensitivity (90%) and specificity (87%) for this 8 PD threshold.

Conclusions:

• A postoperative alignment target of 8 PD is critical for fostering simultaneous perception in surgically treated pediatric esotropia.
• ROC analysis is an effective tool for objectively assessing surgical success in restoring basic binocular function.