Prospective study reveals prism adaptation provides higher early motor success in acquired comitant esotropia, indicating postoperative spectacle adjustment equalizes outcomes.
Key Points
To compare surgical outcomes of preoperative prism adaptation against the augmented surgery formula in patients undergoing surgery for acquired comitant esotropia.
Prospective study evaluating 40 patients allocated to either prism adaptation (n=20) or an augmented surgery formula group (n=20).
Patients in the prism adaptation group received surgery targeted to their prism-adapted angle regardless of responder status, while the augmented surgery group was operated on according to the average of near deviation without correction and distance deviation with correction.
At 3 months postoperatively, motor success was significantly higher in the prism adaptation group (90%, 18/20) than in the augmented surgery group (55%, 11/20) (P = .013).
At 6 months, motor success rates were 95% (19/20) for prism adaptation and 80% (16/20) for augmented surgery (P = .151), reflecting improvements after reducing hyperopic spectacle power to manage consecutive exotropia.