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Abstract Background This study evaluated etiological factors, changes in alignment angle post-surgery, and binocular vision function improvement in Japanese adults with esotropia. Methods This retrospective study included 105 patients with esotropia who underwent surgery at our hospital. We reviewed the medical records to determine the causes of esotropia, patient motivation for surgery, changes in alignment angle post-surgery, improvement in binocular vision function, and correlation between the operated muscle length and corrected eye alignment angle. The alternate prism cover test was performed to assess the angle of misalignment. Binocular vision function was determined using the Titmus Stereo Test, major amblyoscope, Bagolini striated lenses test, and an afterimage test. One-to-four muscle surgery, involving medial rectus muscle recession or lateral rectus muscle resection, was performed. Results The etiologies included acquired progressive esotropia with myopia (n = 51); congenital esotropia (n = 6); partial accommodative esotropia (n = 5); cerebral infarction or cerebral breeding (n = 5); sagging eye syndrome (SES) (n = 5); brain tumors (n = 3); sensory esotropia (n = 2); consecutive esotropia after exotropia surgery (n = 2); face trauma (n = 1); Duane syndrome (n = 1); and unknown origin (n = 24). Eye alignment improved in all patients. However, four patients needed a second operation. Binocular vision function improved in patients with acquired progressive esotropia with myopia; partial accommodative esotropia; cerebral infarction or cerebral breeding; SES; and brain tumors. Binocular vision function was unchanged in patients with sensory and congenital esotropia. Conclusions Esotropia surgery in adults can lead to improved eye alignment and binocular vision function. However, the patients with sensory esotropia and congenital esotropia were unable to acquire binocular vision function.
Yokoyama et al. (Mon,) studied this question.