Esotropia

This study aimed to observe the clinical characteristics of acute acquired concomitant esotropia (AACE) patients in recent five years and to examine the changes in the proportion of AACE cases before and after the COVID-19 pandemic.

A retrospective study included 148 patients who underwent strabismus correction surgery for AACE between January 1, 2017, and December 31, 2021. The study analyzed the changing proportion of AACE cases before and after the COVID-19 pandemic and analyzed its clinical characteristics.

Abnormalities in the worth 4 dot examination (both distance and near) were present in 134 cases (90.54%) before surgery, while 140 cases (94.59%) showed normal results after surgery. Near stereoacuity was present in 135 cases (91.22%). The near and distance deviations were (55.01 ± 18.77) PD and (57.30 ± 17.64) PD, respectively, and there was no significant difference between the two (p = 0.279). There were significant differences in the ratio of refractive status among different age groups (p < 0.001), while no statistically significant difference was observed in the ratio of refractive status for near deviation (p = 0.085) or distance deviation (p = 0.116). The proportion of AACE cases after the COVID-19 pandemic was significantly higher than that before the COVID-19 pandemic (p = 0.042). There was no statistically significant difference in the clinical characteristics between the two groups (p > 0.05).

Myopia is the most common refractive status in AACE. More than half of patients had occupations that involved long hours of close work. The proportion of AACE cases increased significantly after the COVID-19 pandemic.

To evaluate the clinical profile of myopic strabismus fixus (MSF) in children and surgical outcomes of silicone band loop myopexy.

We retrospectively reviewed records of children presenting with MSF who underwent silicone band loop myopexy between January 2008 and December 2020 at a tertiary eye care center. Data concerning demographics, refractive error, axial length, extra-ocular motility, and ocular alignment pre-operatively and post-operatively, intra- and post-operative complications, ocular and systemic associations, were evaluated. The long-term effects of band loop myopexy on ocular alignment stability, motility improvement, and myopia progression were analyzed. Surgical outcome was defined as post-operative orthotropia or heterotropia less than or equal to 20 PD.

A total of0 eyes of 7 patients (median age: 5 years; 5 boys and 2 girls) who underwent band loop myopexy were included in the study. Among them, three children underwent bilateral and four children underwent unilateral band loop myopexy. Medial rectus recession was performed only in two patients as a part of initial procedure. The median follow-up duration was 7 years. Most of the children, i.e. six of them presented with esotropia-hypotropia and only one patient presented with exotropia-hypotropia complex. The median pre-operative measurements were esotropia of 62.5 PD, hypotropia of5 PD, and exotropia of4 PD. Postoperative average primary position deviation measured was close to 9-10 PD of esotropia. The overall motility improved to -1 from -3.

The clinical profile of MSF in children is almost similar to adults. This condition is a rare entity among adults as well as children. Majority of children with MSF presented with esotropia-hypotropia complex. Silicone band loop myopexy with or without medial rectus recession proves to be a reliable surgical procedure as it provides stable outcomes in terms of ocular alignment and motility among children.

Strabismus and Pediatrics Ophthalmology surgeries are pivotal in addressing early-onset visual disorders. An 11-year retrospective study at a tertiary hospital center aimed to elucidate evolving surgical trends, focusing on esotropia cases.

The surgical records from January 2009 to January 2020 were analyzed according to the baseline diagnosis. Esotropia cases were evaluated based on the patients' deviation types, surgical techniques, and pre-operative characteristics. A total of 2050 surgeries were performed over the study period.

Strabismus surgery accounts for 70% of the department's surgical activity. A trend toward a decrease in esotropia surgeries and a proportional increase in exotropia surgeries was noticeable. Esotropia cases, with a median surgical age of 6 years (p25-p75, 4-10) and uniform gender distribution (females, 54.8%), predominantly involved high angular deviations. Posterior fixation sutures emerged as the preferred surgical technique for esotropia.

The study's insights, while aligning with prior European research, introduce new dimensions to the understanding of strabismus surgeries, emphasizing the significance of early interventions, evolving surgical preferences, and the challenges posed by severe deviations.