Surgical modification of the AC/A ratio and the binocular alignment ("Phoria") at distance; its influence on accommodative esotropia: a study of 21 cases.

PURPOSE: To study these changes in patients and their relation to manifestation of accommodative esotropia and response to surgery.

METHODS: Patient-subjects: 21 patients who had difficulty adjusting to spectacle correction and underwent bilateral medial rectus loop suspension-recession surgery to alleviate their accommodative esotropia. Measurements of AC/A, uncorrected distance phoria, and related parameters were taken before and after surgical intervention was performed and were analyzed using analysis of variance (ANOVA).

RESULTS: Both AC/A ratios and the distance phorias are "statistically significantly" (p< or =0.05), and independently, reduced by this surgical procedure. The manifestation of accommodative esotropia and response to surgery can be fairly accurately predicted from the values of AC/A ratio and distance phoria.

CONCLUSION: Surgical treatment of accommodative esotropia creates well defined, long-lasting reductions in the AC/A ratio and the distance phoria.