The long-term outcomes in children who are not compliant with spectacle treatment for accommodative esotropia

Abstract

Purpose: To evaluate the long-term motor and sensory outcomes of children who have refractive accommodative esotropia and are noncompliant with spectacle wear.

Methods: The medical records of patients diagnosed with pure refractive accommodative esotropia between 1999 and 2004 were retrospectively reviewed. All patients had hyperopia of at least 3 D and at least 1 year's follow-up. Patients were classified according to degree of compliance with spectacle wear as good, fair, and poor. The main outcome measures were sensory and motor outcomes.

Results: A total of 92 patients were included. The mean follow-up period was 61.4 months (range, 12-200 months). Compared to patients with good compliance, those with fair compliance had a significantly higher risk for poor sensory outcome (odds ratio [OR] = 4.56; 95% CI 2.1 - 24.7; P = 0.0003) and poor motor outcome (OR = 4.1; 95% CI, 1.44 -11.75; P = 0.0065). Patients with poor compliance likewise had a higher risk for poor sensory outcome (OR = 12.3; 95% CI, 1.29-96.79; P = 0.0061) and poor motor outcome (OR = 11.7; 95% CI, 2.38-74.19; P = 0.0006).

Conclusions: Fair and poor compliance with spectacle use greatly increases the risk of poor sensory and motor outcomes in children with pure refractive accommodative esotropia.