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| Clinical Features and Surgical Effectiveness Assessment of Acute Concomitant
Esotropia |
| Jun Zhang 1,2, Huang'en Li 2, Hongbin Dai 2, Qinmei Wang 1 |
| 1Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
2Eye Hospital of Wuhan Aier, Wuhan 430061, China |
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Abstract Objective: To analyze the clinical features, surgical approach and treatment effect of 101 patients with
acute concomitant esotropia. Methods: One hundred and one patients with acute concomitant esotropia
admitted to Aier Eye Hospital of Wuhan from November 2018 to November 2020 were included in this
retrospective case study, including 71 males and 30 females, ranging in age from 5 to 76 years old, with
an average age of (20.7±11.3) years old. Clinical data were collected, including basic patient data, eye condition, and cranial imaging, and paired t test was used to compare the nearsighted and far-sighted
strabismus. χ
2 test was used to analyze the differences of refractive states in patients of different ages and
genders. Results: Among the 101 patients, 81 cases were myopia and 19 cases were hyperopia. The age
group under 12 years old mainly had hyperopia, the age group 12 to 30 years old mainly had moderate to
high myopia, and the age group above 30 years old mainly had low to moderate myopia. Among them, 71
(70.3%) were aged from 12 to 30 years. Among them, there are 63 students, and 46.5% of them use their
eyes at close range for more than 8 hours. There were 81 cases of myopia and 19 cases of hyperopia in
all patients. Hyperopia was predominant in the age group below 12 years old, medium and high myopia
in the age group from 12 to 30 years old, and low and moderate myopia in the age group above 30 years
old. The near strabismus of naked eye (+42.0±18.3)
? and the far strabismus of naked eye (+43.7±17.2)
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were higher than that of near strabismus (t=2.82, P=0.011). The degree of nearsighted strabismus with
mirror (+41.6±18.6)
? and the degree of far-sighted strabismus with mirror (+43.2±17.7)
? were higher
than that with mirror (t=2.61, P=0.007). Among all patients when seen with naked eyes and with glasses,
the proportion of distal strabismus greater than proximal strabismus is 24.8%, the proportion of proximal
strabismus greater than distal strabismus is 7.9%. The average distance from the medial rectus muscle
insertion to the corneal limbus in 83 cases was 4.74 mm, which was less than the normal value of 5.50 mm.
The most commonly used surgical method in this study was external rectus shortening and internal rectus
retromigration. All patients had a successful operation, and the mean strabismus of patients after surgery
was 0
?. Conclusions: Most of the patients with acute congenital esotropia are teenagers and young people
in their 20 years old, which may be related to the prolonged use of the eyes at close range. Patients with
different refractive states may develop acute concomitant esotropia. Acute concomitant esotropia may
be accompanied by neurological lesions and anatomic abnormalities such as medical rectus insertion.
In patients with acute concomitant esotropia, the proportion of distal strabismus greater than proximal
strabismus was higher than proximal strabismus greater than distal strabismus when seen with naked eyes
and with glasses. The patients treated with medial rectus recession and lateral rectus resection had good
postoperative results.
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Received: 06 December 2021
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Corresponding Authors:
Qinmei Wang, Eye Hospital, Wenzhou Medical University, Wenzhou 325027,China (Email: wqm3@mail.eye.ac.cn)
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