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| Comparison of the Surgical Effects Based on Maddox Prism Test and Prism andAlternative CoverTest forAcuteAcquired Comitant Esotropia |
| Kai Tang, Hongsheng Bi, Jike Song, Jinli Liu, Fang Sha, Yi Liu, Xiuzhen Lu |
| Affliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Shandong Academy of Eye Disease Prevention and Therapy, Shandong University of Traditional Chinese Medicine, Jinan 250002, China |
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Abstract Objective: To compare the surgical effects of using maddox prism test and prism and alternative cover test (PACT) as the target angle for acute acquired comitant esotropia (AACE). Methods: In this retrospective case series study, thirty-four patients with AACE underwent surgery at theAffiliated Eye Hospital of Shandong University ofTraditional Chinese Medicine from January 2020 to March 2022,and were followed up for more than 6 months. According to the examination methods corresponding to the surgical target angle, the patients were divided into two groups: control group (18 cases) and maddox group (16 cases). In the control group, the angle of PACT was used as the surgical target angle. In the maddox group, the maddox prism examination was added preoperatively and used as the surgical target angle. Postoperative deviation was measured by PACT in both groups. Clinical data, including pre- and postoperative deviation, fusion range, and near stereopsis, were collected and compared. A successful surgical alignment wasdefned asthe distant and near deviation in the primary gaze within 8 PDand no diplopia. T-test, Wilcoxon rank sum test, and χ2 test were used for data analysis. Results: In the maddox group, the deviation angle measured by maddox prism was larger than that measured by PACT (6.0±3.9 PD for distance, t=-6.10, P<0.001; 6.6±2.4 PD for near, t=-11.08, P<0.001). At the last postoperative follow-up, the far and near residual strabismus in the maddox group were less than those in the control group (1.6±2.1 PD vs. 4.0±2.8 PD, t=2.75, P=0.010; 3.1±2.2 PD vs. 5.9±3.3 PD, t=2.87, P=0.007). In this study, 14 patients (78%) in the control group and 15 patients (94%) in the maddox group achieved successful surgical alignment after one surgery, with no statistically signifcant difference (P>0.05). The postoperative fusion range in the control and maddox groups increased by 3.9°±3.6° and 4.2°±2.5°, respectively, with no signifcant difference between the two groups (P>0.05). Postoperatively, 10 cases (63%) in the control group and 10 cases (77%) in the maddox group recovered foveal near stereopsis, with no statistically significant difference (P>0.05). Conclusions: Strabismus surgery with PACT and maddox prism as the target angle can effectively improve the ocular alignment, fusion function, and near stereopsis in patients with AACE. However, using maddox prism as the surgical target angle resulted in less postoperative residual deviation.
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Received: 02 November 2022
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| Fund:Development Project of Medicine and Health Science Technology of Shandong Province (2019WS569) |
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Corresponding Authors:
Xiuzhen Lu, Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Shandong Academy of Eye Disease Prevention and Therapy, Shandong University of Traditional Chinese Medicine, Jinan 250002, China (Email: luxzhluxzh@163.com)
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| [1] |
. [J]. Chinese Journal of Optometry Ophthalmology and Visual science, 2023, 25(8): 0-. |
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