Abstract
Purpose: To describe the characteristics of the strabismus, surgical management, and outcomes of patients who underwent surgery for adult-onset esotropia. Methods: This was a retrospective case study of patients at an academic tertiary referral center who underwent surgical treatment of esotropia acquired at or after age 18 years. Primary outcome measures were resolution of diplopia in primary position and a deviation of 10 prism diopters or less in primary gaze. Additional clinical parameters were assessed. Results: Of 248 patients with adult-onset esotropia who underwent strabismus surgery, all experienced diplopia preoperatively except those with sensory esotropia. The four most common diagnoses were cranial nerve VI palsy in 36% (90 of 248), thyroid eye disease in 18% (45 of 248), age-related distance esotropia in 15% (38 of 248), and decompensated latent esodeviations in 13% (31 of 248) of patients. A variety of surgical procedures were employed, and adjustable sutures were used in 79% (196 of 248). Approximately 80% (158 of 197) of patients present at the 2-month postoperative follow-up visit were aligned within 10 prism diopters, and 72% (140 of 195) experienced resolution of diplopia. Success rates were significantly higher in patients with adjustable sutures. Reoperation rates were low overall at 15% (37 of 248) and were highest in cranial nerve VI palsies and lowest in age-related distance esotropia. Dose-response calculations showed a nonsignificantly smaller effect per millimeter of recession and resection in cranial nerve VI palsy and age-related distance esotropia. Conclusions: The causes of adult-onset esotropia are diverse. A variety of surgical approaches are employed and, in conjunction with adjustable sutures, provide a good rate of diplopia resolution and acceptable ocular alignment.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 104-111 |
| Number of pages | 8 |
| Journal | Journal of Pediatric Ophthalmology and Strabismus |
| Volume | 54 |
| Issue number | 2 |
| DOIs | |
| State | Published - 2017 |
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ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Medicine(all)
- Ophthalmology
Cite this
Surgical treatment of adult-onset esotropia : Characteristics and outcomes. / Grace, Sara F.; Cavuoto, Kara M; Shi, Wei; Capo, Hilda.
In: Journal of Pediatric Ophthalmology and Strabismus, Vol. 54, No. 2, 2017, p. 104-111.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Surgical treatment of adult-onset esotropia
T2 - Characteristics and outcomes
AU - Grace, Sara F.
AU - Cavuoto, Kara M
AU - Shi, Wei
AU - Capo, Hilda
PY - 2017
Y1 - 2017
N2 - Purpose: To describe the characteristics of the strabismus, surgical management, and outcomes of patients who underwent surgery for adult-onset esotropia. Methods: This was a retrospective case study of patients at an academic tertiary referral center who underwent surgical treatment of esotropia acquired at or after age 18 years. Primary outcome measures were resolution of diplopia in primary position and a deviation of 10 prism diopters or less in primary gaze. Additional clinical parameters were assessed. Results: Of 248 patients with adult-onset esotropia who underwent strabismus surgery, all experienced diplopia preoperatively except those with sensory esotropia. The four most common diagnoses were cranial nerve VI palsy in 36% (90 of 248), thyroid eye disease in 18% (45 of 248), age-related distance esotropia in 15% (38 of 248), and decompensated latent esodeviations in 13% (31 of 248) of patients. A variety of surgical procedures were employed, and adjustable sutures were used in 79% (196 of 248). Approximately 80% (158 of 197) of patients present at the 2-month postoperative follow-up visit were aligned within 10 prism diopters, and 72% (140 of 195) experienced resolution of diplopia. Success rates were significantly higher in patients with adjustable sutures. Reoperation rates were low overall at 15% (37 of 248) and were highest in cranial nerve VI palsies and lowest in age-related distance esotropia. Dose-response calculations showed a nonsignificantly smaller effect per millimeter of recession and resection in cranial nerve VI palsy and age-related distance esotropia. Conclusions: The causes of adult-onset esotropia are diverse. A variety of surgical approaches are employed and, in conjunction with adjustable sutures, provide a good rate of diplopia resolution and acceptable ocular alignment.
AB - Purpose: To describe the characteristics of the strabismus, surgical management, and outcomes of patients who underwent surgery for adult-onset esotropia. Methods: This was a retrospective case study of patients at an academic tertiary referral center who underwent surgical treatment of esotropia acquired at or after age 18 years. Primary outcome measures were resolution of diplopia in primary position and a deviation of 10 prism diopters or less in primary gaze. Additional clinical parameters were assessed. Results: Of 248 patients with adult-onset esotropia who underwent strabismus surgery, all experienced diplopia preoperatively except those with sensory esotropia. The four most common diagnoses were cranial nerve VI palsy in 36% (90 of 248), thyroid eye disease in 18% (45 of 248), age-related distance esotropia in 15% (38 of 248), and decompensated latent esodeviations in 13% (31 of 248) of patients. A variety of surgical procedures were employed, and adjustable sutures were used in 79% (196 of 248). Approximately 80% (158 of 197) of patients present at the 2-month postoperative follow-up visit were aligned within 10 prism diopters, and 72% (140 of 195) experienced resolution of diplopia. Success rates were significantly higher in patients with adjustable sutures. Reoperation rates were low overall at 15% (37 of 248) and were highest in cranial nerve VI palsies and lowest in age-related distance esotropia. Dose-response calculations showed a nonsignificantly smaller effect per millimeter of recession and resection in cranial nerve VI palsy and age-related distance esotropia. Conclusions: The causes of adult-onset esotropia are diverse. A variety of surgical approaches are employed and, in conjunction with adjustable sutures, provide a good rate of diplopia resolution and acceptable ocular alignment.
UR - http://www.scopus.com/inward/record.url?scp=85016228329&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85016228329&partnerID=8YFLogxK
U2 - 10.3928/01913913-20160929-02
DO - 10.3928/01913913-20160929-02
M3 - Article
C2 - 28092393
AN - SCOPUS:85016228329
VL - 54
SP - 104
EP - 111
JO - Journal of Pediatric Ophthalmology and Strabismus
JF - Journal of Pediatric Ophthalmology and Strabismus
SN - 0191-3913
IS - 2
ER -