Comparing Park Table - Augmented and Standard Surgical Doses in Acute Acquired Comitant Esotropia: A Retrospective Analysis
Worapot Srimanan Division of Ophthalmology, Phramongkutklao Hospital, Bangkok, ThailandCorrespondence: Worapot Srimanan, Division of Ophthalmology, Phramongkutklao Hospital, 315 Ratchawithi Road, Thung Phayathai Subdistrict, Ratchathewi, Bangkok, Thailand, Tel +662-763-9300, Fax +662-354-9309, Email...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2025-07-01
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| Series: | Clinical Ophthalmology |
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| Online Access: | https://www.dovepress.com/comparing-park-table---augmented-and-standard-surgical-doses-in-acute--peer-reviewed-fulltext-article-OPTH |
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| Summary: | Worapot Srimanan Division of Ophthalmology, Phramongkutklao Hospital, Bangkok, ThailandCorrespondence: Worapot Srimanan, Division of Ophthalmology, Phramongkutklao Hospital, 315 Ratchawithi Road, Thung Phayathai Subdistrict, Ratchathewi, Bangkok, Thailand, Tel +662-763-9300, Fax +662-354-9309, Email drworapotsmn@gmail.comPurpose: Acquired comitant esotropia (ACE) is a rare condition characterized by the sudden onset of inward eye deviation. In non-recovered cases, surgery was performed. The standard surgical dose typically leads to undercorrection, and multimodal approaches were used to enhance outcomes. The current study aimed to explore the clinical course and identify factors influencing surgical success in patients with ACE at a tertiary hospital.Patients and Methods: This retrospective study reviewed the electronic medical records of 99 patients diagnosed with ACE at Phramongkutklao Hospital between 2014 and 2024. Data collected included patient demographics, underlying etiologies, clinical presentations, treatment approaches, and surgical outcomes. Surgical cases were categorized based on the use of either the standard Park surgical dosage or an augmented dose, defined as an additional 0.5 mm beyond the standard amount. Factors associated with successful surgical outcomes were also evaluated through statistical analysis.Results: The mean age at diagnosis was 28.97 ± 19.67 years, with a slight predominance of men. ACE was classified as types I (Swan type), II (Burian–Franceschetti), and III (Bielschowsky) in 8.08% (8/99), 46.46% (46/99), and 45.45% (45/99), respectively. All cases were idiopathic, with neuroimaging abnormalities detected in 4.04% (4/99) of patients. Surgical intervention was required in 79.8% (79/99) of cases. One year postoperatively, 75% (54/72) of patients demonstrated substantial improvement in ocular alignment. Based on subgroup analysis, the success rate was 91.18% in the augmented group and 60.53% in the non-augmented group. Logistic regression analysis indicated that an augmented surgical dose was significantly associated with favorable surgical outcomes (adjusted odds ratio: 5.50; 95% confidence interval [95% CI], 1.32– 22.89).Conclusion: This study demonstrates a high surgical success rate in patients with ACE, supporting the potential use of augmented surgical doses. Further research is warranted to identify additional prognostic factors and refine treatment strategies for optimal ACE management.Plain Language Summary: Acquired comitant esotropia (ACE) is a rare eye condition in which one or both eyes suddenly turn inward, often causing double vision. When conservative treatments like glasses or prisms fail, surgery is usually required. However, the standard surgical approach can sometimes result in undercorrection, prompting the use of adjusted, or “augmented”, surgical doses to improve outcomes.In this study, we reviewed the records of 99 patients treated for ACE at a tertiary hospital in Thailand between 2014 and 2024. Most patients eventually required surgery, and those who received an augmented surgical dose—an extra 0.5 mm beyond the standard measurement—had significantly better results. One year after surgery, about 75% of patients showed marked improvement in eye alignment. Statistical analysis revealed that using an augmented dose increased the likelihood of surgical success by more than five times.These findings support the use of augmented surgical dosing in ACE and suggest that tailoring the surgical dose may lead to better outcomes. More studies are needed to further refine surgical techniques and identify other factors that influence success.Keywords: acquired comitant esotropia, clinical course, etiology, incidence, surgical outcomes, tertiary hospital |
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| ISSN: | 1177-5483 |