Repeated surgery for acute acquired esotropia: is it worth the effort?

Purpose. Good binocular potential has been a fundamental defining characteristic of acute acquired concomitant esotropia (AACE) type II. The purpose of this study was to ascertain the clinical features and surgical outcome in children with AACE type II who underwent repeated surgery for the sake of binocularity. Methods. In 4 children with AACE type II, repeated surgery was performed between 1995 and 2008. These cases are presented with special attention to their long-term follow-up and their binocularity outcome. Results. The final binocularity outcome was high-grade stereopsis (Lang I/II positive) in all 4 cases. The duration from onset of esotropia to the time of regained stereovision was between 20 and 62 months. In one case, high-grade stereoacuity was only achieved after a second surgery. Conclusions. Our findings support the good binocular potential in patients with AACE type II. Despite a complicated course and long-lasting absence of stereovision, all patients eventually regained high-grade stereopsis. Resolutely aiming at realignment seems to be worth the effort. (Eur J Ophthalmol 2010; 20: 493-7)