ArticleGraefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie2026
Evaluation of surgical outcomes and intervention threshold for small-angle acute acquired comitant esotropia.
Article in Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThis study aims to evaluate the safety and efficacy of surgical treatment for small-angle (≤ 15 prism diopters [PD]) acute acquired comitant esotropia (AACE), provide preliminary dose-response estimates and explore the surgical thresholds.
methods25 patients with small-angle AACE(10-15 PD) underwent unilateral medial rectus (MR) recession with or without lateral rectus (LR) resection, with at least 6 months of follow-up. Causal mediation and multivariable linear regression analysis evaluated the surgical dose-response relationship. Linear modeling estimated the minimum horizontal deviation (surgical threshold) in AACE.
resultsThe surgical success rate was 96% (24/25). Mean distant deviation decreased to 0.56 ± 2.12 PD postoperatively (P < 0.001). Fine near stereoacuity increased from 4% to 72%, and those achieving fine or moderate distance stereoacuity from 0% to 72% (both P < 0.001). The base-out recovery point at distance mediated 82.6% of the total effect on the surgical dose (P < 0.001), with adjusted dose responses of 3.76 PD/mm (95% CI, 2.35-5.16; P < 0.001) for MR recession and 3.46 PD/mm (95% CI, 2.62-4.30; P < 0.001) for LR resection. Linear modeling indicated that a recovery point of 15 PD corresponded to a predicted horizontal deviation of 9.96 PD, closely aligning with the lowest distant horizontal deviation (10 PD) observed in this study.
conclusionSurgery for small-angle AACE is safe and effective. It may serve as a viable option for patients with deviations as small as 10 PD and a base-out recovery point of at least 15 PD at both near and far, pending validation in larger prospective cohorts.
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