Partially Accommodative Esotropia
Conditions
Keywords
esotropia, accommodative, hyperopia, recession, fenestration
Brief summary
This prospective comparative study aims to compare medial rectus (MR) muscle fenestration and recession in patients with partially accommodative esotropia (PAET). The main question it aims to answer is whether MR fenestration is equally effective as MR recession for PAET. All patients will receive complete ophthalmic and orthoptic assessment. Patients will be randomly allocated using a random table to one of two groups; Group 1 will receive conventional MR recession, and Group 2 will receive MR fenestration.
Detailed description
Inclusion criteria The study will include patients with accommodative esotropia if the residual distance deviation with full cycloplegic correction is \> 15PD. Exclusion criteria: 1. Patients with convergence excess esotropia, defined as a near deviation with glasses exceeding that for distance by 15 PD or more. 2. Patients with paralytic or restrictive strabismus. 3. Patients with previous strabismus surgery 4. Patients with neurologic, ocular, or developmental disorders or follow-up less than 6 months All patients will receive complete ophthalmic and orthoptic assessment including: i) A full ophthalmological assessment including history taking, measurement of uncorrected and best-corrected visual acuity, cycloplegic refraction, anterior segment examination, as well as a dilated fundus examination. ii) Measurement of the deviation at distance (6 m) and near (33 cm). iii) Assessment of ductions and versions in all cardinal directions of gaze Patients will be randomly allocated using a random table to one of two groups: 1. Group 1: Unilateral or bilateral conventional MR recession. Augmented formula will be used to decide the Surgical dosage using the standard tables (3) 2. Group 2: unilateral or bilateral MR fenestration All surgeries will be performed by one experienced surgeon (H.SH)
Interventions
PROCEDUREmedial rectus fenestration
Fenestration technique involves making two splitting incisions by blunt dissection parallel to the muscle fibers on the superior and inferior borders of the muscle, leaving 1 mm of muscle fibers on each edge. The rectangular wide central part is excised from the insertion and between the two splitting incisions to a point back 5-8 mm depending on the angle of the esotropia.
PROCEDUREmedial rectus recession
recession is one of the gold standard weakening procedures that involves disinsertion of the muscle and re-suturing to the sclera at a more posterior location to decrease its contractile power.
Sponsors
Mansoura University
Tanta University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* patients with accommodative esotropia if the residual distance deviation with full cycloplegic correction is \> 15PD.
Exclusion criteria
1. convergence excess esotropia. 2. paralytic or restrictive strabismus. 3. previous strabismus surgery 4. neurologic, ocular, or developmental disorders or follow-up less than 6 months
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Ocular alignment (measured in prism diopters) | 6 months postoperative | The distance and near angles of deviation, with and without glasses, and the angle disparity |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| ocular motility | 6 months postoperative | ductions of both eyes (graded on a scale of nine points from -4 to +4) |
Countries
Egypt
Contacts
Primary ContactAmeera G Abdelhameed, MD
Outcome results
None listed