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Long-term surgical outcomes of preoperative prism adaptation in patients with partially accommodative esotropia

Eye volume 35, pages 1165–1170 (2021)Cite this article

Subjects

Abstract

Background:

To determine the long-term surgical outcomes of preoperative prism adaptation test (PAT) in patients with partially accommodative esotropia.

Methods:

PAT was performed for the remaining esotropia after full correction of hyperopia. Prism adaptation (PA) responders were defined as patients with stable esodeviation between 0 and 8 prism diopters (PD) while developing sensory fusion throughout the prism adaptation period. Surgical success was defined as a deviation within 8 PD of both the far and near deviation angles at the last follow-up examination.

Results:

Of the 102 patients, 43 (42.2%) were PA responders, and 59 were PA non-responders (57.8%). After a mean follow-up duration of 6 years after surgery, the surgical success rate was significantly higher in PA responders (76.7% vs. 54.2%, p = 0.023). By multivariate analysis, good stereoacuity at near before surgery significantly correlated with successful outcomes after surgery (p = 0.001, β = 4.466). The risk factors of undercorrection were preoperative esotropia >35 PD (OR 3.067, p = 0.041), and preoperative hyperopia >+5.25 diopters (OR 3.099, p = 0.049). Among undercorrected patients, the annual decrease of esodeviation was significantly greater in PA responders (p = 0.043).

Conclusions:

PA responders showed a better long-term success rate than in PA nonresponders. Patients with high hyperopia and large esotropia had a higher risk of undercorrection. Undercorrected patients eventually achieved good motor outcome with postoperative prism correction if they were PA responders before surgery.

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Data availability

Data are available on request. Any requests for data can be made to the corresponding author and are subject to ethics approval.

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Funding

The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

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Affiliations

  1. Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea

    Dong Hyun Kim, Hee Kyung Yang & Jeong-Min Hwang

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  1. Dong Hyun Kim
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  2. Hee Kyung Yang
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  3. Jeong-Min Hwang
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Contributions

All authors took an active part in the design, conduct, data analysis, and publication drafting and approval.

Corresponding author

Correspondence to Jeong-Min Hwang.

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The authors declare that they have no conflict of interest.

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The Institutional Review Board of Seoul National University Bundang Hospital (IRB No.: SNUBH B-2004/607-102)

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The Institutional Review Board of Seoul National University Bundang Hospital waived the requirement of informed consent. Patient records and information were anonymized prior to access.

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Kim, D.H., Yang, H.K. & Hwang, JM. Long-term surgical outcomes of preoperative prism adaptation in patients with partially accommodative esotropia. Eye 35, 1165–1170 (2021). https://doi.org/10.1038/s41433-020-1086-7

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  • DOI: https://doi.org/10.1038/s41433-020-1086-7

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