Factors affecting the motor outcome after corrective surgery for acquired comitant esotropia

Abstract

Purpose: To determine the possible predictors of the motor outcome after corrective surgery for acquired comitant esotropia. Methods: The study included 40 patients with acquired comitant esotropia. After evaluation of the visual, sensory, and motor status; cycloplegic refraction; fundus examination; and spectacle prescription, all patients underwent corrective strabismus surgery. A successful motor outcome was defined as 0 to 10 prism diopters of horizontal tropia. Statistical analysis of the results was done using the chi-square tests. Results: At the sixth postoperative month, 90% achieved a successful motor outcome, while 2.5% had a consecutive exotropia >10 prism diopters, and 7.5% had a residual esotropia >10 prism diopters. A statistically significant relationship existed between the motor outcome and the following: preoperative results of the Worth four-dot test at 6 m ( p = .011) and 0.33 m ( p = .009), preoperative distant ( p = .016) and near ( p = .017) angles of esotropia with glasses, postoperative near angles of deviation at 1 week ( p = .005), 1 month ( p < .001), 6 weeks ( p < .001), 3 months ( p = .001), and 6 months ( p < .001) following surgery, postoperative distant angles of deviation at 6 weeks ( p < .001) and 3 months ( p = .03) following surgery, 6 week ( p  = .01) and 6 month ( p  = .036) postoperative results of the Worth four-dot test at 0.33 m, and the 6-month postoperative sensory outcome ( p  = .006). Conclusion: Preoperative and postoperative sensory and motor functions are predictors of the 6-month postoperative motor outcome.