Fifteen-year outcome of surgery for the near angle in patients with accommodative esotropia and a high accommodative convergence to accommodation ratio

Objective: To determine the 15-year outcome of patients with partly accommo dative esotropia with a high accommodative convergence to accommodation (AC /A) ratio who underwent surgery based on the angle of esotropia at one-thir d meter while wearing full hyperopic correction. Methods: A retrospective chart review to determine the 15-year outcome of 2 5 patients whose 6-month outcome had been previously reported as part of a prospective, randomized, masked clinical trial. All patients had partly acc ommodative esotropia with a high AC/A ratio and underwent surgery based on their esotropia at one-third meter while wearing full-distance optical corr ection. Results: Fifteen years after surgery, 19 of the 22 patients for whom follow -up data are available had between 0 and less than 10 prism diopters of eso tropia. Only 6 of the 19 needed to continue to wear optical correction to m aintain satisfactory alignment; however, 8 more needed spectacles for visua l purposes. Only 1 patient needed to use a bifocal add to have satisfactory alignment at one-third meter. All patients showed some degree of sensory f usion, with 4 obtaining 40 seconds of stereopsis and another 8 obtaining be tween 60 and 200 seconds of stereopsis. Conclusion: Surgery for the near angle obtained with 0 patients wearing the ir full hyperopic distance correction provides excellent motor and sensory results in patients with partly accommodative esotropia with a high AC/A ra tio.