ROC-based validation of an 8-prism diopter surgical target angle in comitant esotropia.

PURPOSE: This study aimed to identify the optimal postoperative ocular alignment that promotes the development of simultaneous perception - the most basic level of binocular vision - in children undergoing surgery for comitant esotropia. The research question focused on whether receiver operating characteristic (ROC) analysis could objectively determine the ideal alignment threshold to support binocular cooperation.

METHODS

A retrospective analysis was conducted on the medical records of pediatric patients diagnosed with childhood comitant esotropia. Among these, a subset underwent strabismus surgery. Postoperative outcomes were evaluated using ROC curve analysis to determine the alignment range most predictive of achieving simultaneous perception.

RESULTS

Of the 99 patients reviewed, 87 underwent surgical correction. ROC analysis revealed that achieving a postoperative alignment within 8 prism diopters (PD) was strongly associated with the development of simultaneous perception. Specifically, alignment within this range yielded a sensitivity of 90% and a specificity of 87%, confirming its predictive value for binocular function recovery.

CONCLUSION

Postoperative alignment within 8 PD represents a critical target for promoting simultaneous perception in pediatric patients treated surgically for comitant esotropia. ROC analysis proved to be a valuable tool for objectively defining surgical success in restoring foundational binocular cooperation.