Strabismus Long Term Outcome for Partial Accommodative Esotropia Surgery

Thanks to Dr. Dom Maino for his blog post as follows:

Partially accommodative esotropia is an acquired strabismus characterized by high hyperopia, a normal AC/A ratio, and a deviation that responds only partially to spectacle correction. …. This retrospective study was done to determine the risk factors for a poor surgical outcome, and to evaluate the efficacy of hyperopic spectacle reduction in the long-term management of consecutive exotropia. Of the 108 patients enrolled, 19% had a residual esotropia, 37% were surgical successes, and 44% developed consecutive exotropia. ….The high rate of consecutive exotropia following standard surgery suggests that augmented surgery for partially accommodative esotropia is highly likely to result in overcorrection.

Comments: Surgery for strabismus can have very poor outcomes. Where are the placebo controlled, double-blind, prospective, randomized clinical trials to support surgery for strabismus? Why do 3rd parties pay for this procedure when it’s outcomes are so variable? Why do OMDs perform this procedure if they do not have the NEI supported clinical trials to produce the “evidence based medicine” needed to justify the time, expense and potential risky outcomes (even if death is unlikely….this is a surgical procedure that requires general anesthesia)? This article is available free by clicking on the title above. DM

Click here to read the article

By Dr. Lynn Hellerstein, Colorado Optometrist in Vision Therapy & Visual Processing