Long-term motor and sensory outcomes after surgery for high AC/A ratio esotropia
Reviewed by Fiona Rowe

This study reports the long-term ocular alignment and sensory outcomes after medial rectus recession for high accommodative convergence to accommodation (AC/A) ratio esotropia with a minimum postoperative follow-up of five years. The study included 34 patients (16 male); 31 had a hyperopic mean spherical equivalent of 3.19 ±1.43D, three with myopia mean of 3.04 ±2.92D and 12 with amblyopia. Bifocals were used by 23 children preoperatively for a mean of 6 ±3.45 years. Bilateral medial rectus recession was undertaken for 26 children with eight having unilateral surgery. Two had inferior oblique recession for coexistent bilateral inferior oblique overaction. At the last follow-up, 62% had surgical success, 20% recurrence, 9% basic esotropia and 9% consecutive exotropia. Surgical success was significantly greater in those with preoperative binocular vision. Recurrence of high AC/A esotropia was at a mean of 5.4 ±2.7 years. Overall, long-term motor and sensory success was documented in two-thirds of children. Bifocal glasses use was eliminated in 70% and one-quarter had stereoacuity postoperatively.

Long-term ocular alignment and sensory outcomes after medial rectus recession for high AC/A ratio esotropia.
Mohan K, Sharma SK.
JOURNAL OF PEDIATRIC OPHTHALMOLOGY AND STRABISMUS
2024;61(5):344–50.