Purpose: To evaluate changes in refraction and corneal curvature following surgery for correction of acquired esotropia. Methods: 42 eyes of 21 patients with acquired moderate angle esotropia without any other form of strabismus were prospectively enrolled and submitted to a complete ophthalmological examination followed by recess/resect procedure in a single eye. Data from the fellow eye were selected as control. Ophthalmological assessment was carried out preoperatively, 1 month after surgery and 6 months after surgery, where astigmatism was compared using vector analysis and the polar value concept. Results: The eyes submitted to surgery revealed a significant (p<0.05) decrease in spherical equivalent, from 3.28 ± 1.98 diopters to 3.05 ± 1.95 diopters. Refraction data disclosed a significant increase in the 90° component of net astigmatism, from 0.458 ± 0.594 diopters to 1.002 ± 0.718 diopters, which was also observed in keratometric readings:1.083 ± 0.560 diopters to 1.690 ± 0.591 diopters. Surgically induced astigmatism, assessed using refraction data was 0.63 ± 0.27 diopters at an average axis of 92.30 ± 14.91 degrees, and 0.71 ± 0.27 diopters at an average axis of 94.45 ± 15.69 degrees as obtained by keratometric readings. This is visually demonstrated by the corneal topography difference map. Conclusions: There is a statistically significant and clinically relevant increase in with-the-rule astigmatism in esotropic patients submitted to monocular recess/resect surgery. This change is stable at a 6 month follow-up and is associated with a decrease in mean spherical equivalent.
Esotropia; Ocular refraction; Strabismus; Astigmatism; Operative surgery procedures
