Clinical Study
Eye (2006) 20, 325–328. doi:10.1038/sj.eye.6701874; published online 3 June 2005
Resolution in partially accomodative esotropia during occlusion treatment for amblyopia
F Koc1, H Ozal1, H Yasar1 and E Firat1
1Strabismus, SSK Ankara Eye Disease Hospital, Ulucanlar, Ankara, Turkey
Correspondence: F Koc, Kuzgun Sok 48/3, Asagi Ayranci 06540, Ankara, Turkey. Tel: +90 312 468 74 59; Fax: +90 312 3124827. E-mail: dr_feray@yahoo.com
Received 11 November 2004; Accepted 15 February 2005; Published online 3 June 2005.
Abstract
Purpose
To evaluate alignment changes in partially accommodative esotropia during occlusion treatment for amblyopia.
Method
Changes at the deviation angles of 63 partially accommodative esotropia patients, who had occlusion treatment for amblyopia, were evaluated retrospectively.
Results
Mean deviation angle at the start of therapy without glasses was 45 PD (10–90 PD) and became 27 PD (5–70 PD) after at least 2 months with glasses. During 12 (2–36) months of occlusion period, mean manifest deviation angle with glasses decreased to 11 PD (0–50) (P<0.001) and amblyopia resolved in 71.5% of the cases. After termination of amblyopia treatment 24 (38%) cases had surgery for the residual deviation but if we had planned surgery before amblyopia treatment, 81% of the patients would have had surgery.
Discussion
Should amblyopia be treated initially or should we operate first in patients with strabismus and amblyopia together? Our research suggests that we should not hurry to operate in high hypermetropic partially accommodative cases, which have amblyopia and a long-term history of strabismus. Initial amblyopia treatment in these cases allows time for resolution of the nonaccomodative component in strabismus and can significantly decrease the necessity for surgery.
Keywords:
amblyopia, accomodation, esotropia, occlusion treatment, surgery
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