Occurrence and Risk Factors of Decompensation and Additional Treatment in Refractive Accommodative Esotropia

Purpose: To examine the occurrence and risk factors of decompensation and the additional treatment of increased hyperopia in refractive accommodative esotropia. Methods: Seventy children with refractive accommodative esotropia were followed up for at least 2 years. Time of decompensation and additional treatment, initial refractive error, initial deviation, and controlled deviation were all studied. Results: Decompensation and additional treatment occurred on average at 21.8 months and 22.2 months in eight patients, respectively, and constant survival was achieved after 4 years of full correction of the refractive error, as shown on a Kaplan-Meier survival curve. In the decompensation, additional treatment and control groups, initial refractive errors were 3.97±1.07D, 4.06±1.92D and 4.60±1.29D, respectively; initial deviations were 36.25±12.75PD, 31.25±10.61PD and 26.02±8.62PD, respectively; and controlled deviations were 4.50±6.30PD, 4.50±4.63PD and 2.65±4.10PD, respectively. There was a significant difference in initial deviation between the decompensation and control groups (p=0.011). Conclusions: The treatment of decompensation and increased hyperopia warranted careful follow-up in the first 4 years after treatment, and patients with large initial deviation risked decompensation.ope