Long-term follow-up of children with acute acquired concomitant esotropia

Abstract

Purpose

To study the clinical features and surgical outcome of type 2 (Burian-Franceschetti) acute acquired concomitant esotropia (AACE).

Methods

Retrospective analysis of children with AACE type 2. All patients underwent strabismus surgery to restore ocular alignment. All children underwent a complete assessment including medical history and pre- and postoperative ophthalmological and orthoptic examinations. Postoperative follow-up was at least 12 months in all cases.

Results

A total of 25 consecutive patients were included. All but 2 patients (92%) were aligned within 8^∆ or less of orthotropia. Of the 25, 15 (60%) regained normal stereovision. In 6 additional cases (24%) some level of binocular vision (Titmus test, 200″ to 3000″) was demonstrated. All of the patients who finally achieved normal stereopsis had lower levels of binocularity on the first postoperative day. The mean interval between surgery and first occurrence of full stereovision was 18 months (range, 2 to 58 months).

Conclusions

General features of AACE type 2 are concomitance of strabismus, absence of an accommodative component even in the presence of hyperopic refractive errors, and no neurological pathology. The potential for normal binocular vision plays a key role in defining this entity. The reemergence of full stereopsis may take several years.