The management of childhood
esotropia with hyperopia.
(La prise en charge de l'esotropie infantile avec hypermétropie)
Zou YC, Liu L.
Department of Ophthalmology, West China School of Clinical Medicine, Sichuan
University, China
PURPOSE : Esotropia,
especially accommodative estropia (AE), is often seen in patients with hyperopia.
In this paper, the authors aim to report the management methods of different
types of esotropia in children with hypermetropia and to show the feasibility
and efficacy of prismatic correction in the management of small angle of
residual esotropia in accommodative estropia.
METHODS : A total of 82 esotropes with hyperopia treated during a 2-year
period from 2007 to 2009 were reviewed retrospectively. Data were collected from
the medical records.
RESULTS : A total of 25 patients showed pure accommodative esotropes,
whereas 45 had partial AE and 12 non-AE. All 25 pure AE patients were corrected
fully using glasses alone, and all 12 non-AE patients received surgery. Among
the 45 partial AE cases, 35 patients with residual esodeviation of =30?PD
received prismatic correction, with a success rate of 71.4% (25 of the 35
patients). The remaining 10 children who were not successfully treated with
prismatic correction and the other 10 partial AE with residual esodeviation of
>30?PD received surgery. The most recent follow-up examination indicated that
all the non-surgical children were orthotropia or esophoria or had residual
esotropia =10?PD. Among the surgical patients, 5 patients (5 in 32 or 15.6%)
exhibited unstable alignment during the postoperative follow-up period, and 10
patients (10 in 32 or 31.25%) underwent additional surgery for residual
esotropia.
CONCLUSIONS : Treatment of estropia in children with hyperopia includes
wearing glasses, glasses combined with prism glasses and surgery. Prismatic
correction in the treatment of small angle of residual esotropia in partial AE
was feasible and efficacious. Since the follow-up lasted only a year, a
long-term follow-up is needed in future studies to investigate the efficiency of
the treatments.
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