Clinical analysis and surgical exploration of acute acquired concomitant esotropia
Objective To investigate the clinical features,etiology,and surgical treatment of acute acquired con-comitant esotropia.Methods A retrospective study was conducted to collect 59 patients with acute acquired concomitant esotropia who underwent surgical treatment by the same chief surgeon at Hefei Bright Eye Hospital from May 2019 to March 2023.After a systematic analysis of the ophthalmic examination,neostigmine test,exclusion of history of trauma,amblyopia treatment cover up,and exclusion of cranial and orbital diseases in computed tomography(CT)or magnetic resonance imaging(MRI),according to the degree of strabismus in both far and near views and the dominant eye,the total correction was designed and the diplopia,eye position and eye movement were observed before and after the operation,the binocular simultaneous vision and stereoscopic vision were examined with synoptophore and Titmus.Results 59 cases were treated by operation:no strabismus in both distant and near vision,no diplopia and normal eye movement,prism+Markov Rod Examination:the degree of slant≤±10 PD(at the first day after the operation:56 cases,at the first month af-ter the operation:53 cases,at the sixth months after the operation:53 cases),+10 PD~+15 PD(3 cases at the first day after the operation,6 cases at the first month after the operation,6 cases at the sixth months after the operation),during 6 months follow-up,no strabismus recurred and no diplopia occurred.Conclusions Acute acquired concomitant esotropia mostly occurs in myopic patients,and it is related to excessive use of eyes at short distance.Patients whose course of dis-ease is more than 6 months should be operated on as soon as possible.The preoperative evaluation of strabismus and the de-sign of the operation should be sufficient,and the effect of the end of the operation should be close to the eyes with external and far eyes with internal strabismus.After the operation,the diplopia disappeared and the binocular visual function was restored to a satisfactory effect.