Clinical characteristics and surgical outcomes of acute acquired Comitant Esotropia

Background To describe the clinical characteristics and the outcomes of strabismus surgery for acute acquired comitant esotropia (AACE). Methods Medical records of 45 AACE patients were retrospectively analyzed. The insertion location of medial rectus was compared between the AACE patients and comitant exotropic patients. The location was also compared with those measured in other studies. Surgical outcome measurements included amount of deviation and level of binocularity at last follow-up. Results The distance from medial rectus to limbus was shorter in AACE patients than in patients with comitant exotropia. The distance was also shorter in AACE patients than patients in other studies. Out of the 45 patients, 2 had neurological diseases. Neostigmine test was negative in all patients. The age at onset of AACE was 5-47 years (mean 19.1 +/- 7.3 years), one patient was 5 years (2.2%), 20 patients were 11-17 years (44.5%) and the other 24 patients were 18-47 years old (53.3%). The mean cycloplegic refraction was - 4.1 +/- 3.0 diopters (D) and 41 patients were myopic (91%). The angle of deviation was 40.5 +/- 19.5 prism diopters (PD) at distance and 35.6 +/- 19.9PD at near preoperatively. The angle was 0.8 +/- 1.6 PD at distance and 0.7 +/- 1.8 PD at near postoperatively. Diplopia resolved in patients who underwent strabismus surgery, with no recurrence during the follow-up period. Thirty patients had stereopsis postoperatively. Conclusions AACE seems to occur mostly in older children and adults and myopes. The distance from the insertion to limbus of medial rectus was shorter in patients with AACE. Good results can be achieved by strabismus surgery.