Augmented-dose surgery based on the single Maddox rod test for acute acquired comitant esotropia.

PURPOSE: To compare the outcomes of augmented-dose surgery for acute acquired comitant esotropia (AACE) based on either the single Maddox rod test (SMRT), or the prism and alternate cover test (PACT), in cases where there is a clinically significant difference in the deviation using the two tests.

METHODS

The medical records of AACE patients who underwent augmented-dose surgery with a difference of ≥5Δ in preoperative deviations on PACT and SMRT were reviewed retrospectively. Augmented-dose surgery was based on the SMRT or PACT. Success was defined as elimination of diplopia and deviations ≤10Δ assessed with the PACT (PACT success) or with the SMRT (SMRT success) at both near and distance.

RESULTS

There were 18 patients in the SMRT group and 15 in the PACT group. In the SMRT group, the rate of PACT success was 94%, and SMRT success, 78%; postoperative distance esodeviation on PACT and SMRT were 0.72Δ ± 1.64Δ and 5.94Δ ± 4.73Δ, respectively. In the PACT group, the rate of PACT success was 80%, and SMRT success, 33%; postoperative distance esodeviation was 4.07Δ ± 5.15Δ (PACT) and 13.73Δ ± 7.96Δ (SMRT). The SMRT success rate was significantly higher in the SMRT group than in the PACT group (P = 0.010). The postoperative distance deviation was smaller in the SMRT group (P < 0.05).

CONCLUSIONS

In our cohort of AACE patients, those whose augmented-dose surgery was based on the SMRT achieved more favorable surgical outcomes than those based on the PACT when there was a difference of ≥5Δ in preoperative deviations assessed with the two methods.