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High Accommodative Convergence/Accommodation Ratio Consecutive Esotropia Following Surgery for Intermittent Exotropia: Clinical Feature, Diagnosis, and Treatment

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Abstract
Consecutive esotropia is a common and stereopsis-threatening consequence of surgery for intermittent exotropia. However, too little attention has been paid to the accommodative convergence per accommodation (AC/A) ratio in this condition. We aimed to describe the clinical features of patients who developed consecutive esotropia with a high AC/A following surgery for intermittent exotropia, compared to those with normal AC/A. In this retrospective cohort study, we identified 54 patients with consecutive esotropia who remained esotropic at one month after surgery. Patients were divided into two groups: normal AC/A and high AC/A groups. Clinical features and outcomes were compared between the two groups. Fourteen (25.9%) of the 54 were classified as high AC/A consecutive esotropia. Good preoperative control at near was the only significant preoperative factor associated with the development of high AC/A consecutive esotropia. Bifocal glasses were prescribed for all patients with high AC/A consecutive esotropia, and 11 (78.6%) of them achieved satisfactory alignment at distance and near fixations using bifocals. Patients with high AC/A consecutive esotropia had a significantly more successful alignment (0.9 vs. 13.0 prism diopters, p < 0.001) and better stereopsis (67.9 vs. 670.0 arc seconds, p = 0.04) than the normal AC/A counterparts at the final follow-up. We suggest that high AC/A consecutive esotropia could be successfully managed by wearing bifocals in most cases. A high AC/A ratio in patients with consecutive esotropia may be considered as a clinical marker heralding a better prognosis.
Author(s)
이병주임현택
Issued Date
2021
Type
Article
Keyword
consecutive esotropiahigh accommodative convergence/accommodation ratiointermittent exotropia
DOI
10.3390/jcm10102135
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7677
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_doaj_primary_oai_doaj_org_article_82a5362d00874da0832b9e4bb035bad6&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,High%20Accommodative%20Convergence%2FAccommodation%20Ratio%20Consecutive%20Esotropia%20Following%20Surgery%20for%20Intermittent%20Exotropia:%20Clinical%20Feature,%20Diagnosis,%20and%20Treatment&amp;offset=0&amp;pcAvailability=true
Publisher
JOURNAL OF CLINICAL MEDICINE
Location
스위스
Language
영어
ISSN
2077-0383
Citation Volume
10
Citation Number
10
Citation Start Page
0
Citation End Page
0
Appears in Collections:
Medicine > Medicine
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