Clinical characteristics and surgical outcomes of adults with acute acquired comitant esotropia

Purpose To investigate clinical characteristics of adults with acute acquired comitant esotropia and to evaluate the muscle recession amount needed to achieve a favorable outcome after performing medial rectus muscle recession. Study designs Retrospective study. Methods Patients diagnosed with acute acquired comitant esotropia, who underwent medial rectus muscle recession with adjustable suture between 2008 and 2016 were included. Surgical outcomes were classified into motor and sensory. The motor outcomes were evaluated at the 1-year postoperative visit and divided into success (orthotropia or esodeviation <= 8 PD) and failure (esodeviation > 8 PD). The successful sensory outcomes were defined as elimination of diplopia in primary gaze. Factors including age, sex, refractive error, deviation angle, and surgical amount were compared between groups. Results Sixteen subjects were included whose mean (+/- SD) age at the initial visit was 27.5 +/- 11.0 years. Mean preoperative maximum angle of deviation was 27.9 +/- 9.3 PD at distance and 28.6 +/- 12.0 PD at near. Mean refractive error was -2.55 +/- 2.92 D. Twelve of 16 subjects (75%) had successful motor and sensory outcomes. Age, sex, refractive error and deviation angle were not different between the two groups. Both success and failure groups required a greater amount of medial rectus muscle recession than those indicated by the Parks' surgical table, with a 40.6 +/- 25.8 % augmentation in the success and 7.9 +/- 6.9 % in the failure group (P = .028). Conclusions To achieve better surgical outcomes in adults with acute acquired comitant esotropia, targeting postoperative orthotropia by increasing the amount of medial rectus muscle recession is recommended.