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Research Mentor Name

Reecha Bahl

Research Mentor Email Address


Institution / Department

Kresge Eye Institute/Ophthalmology

Document Type

Research Abstract

Research Type


Level of Research



PURPOSE: To assess if high accommodative convergence/accommodation (AC/A) ratio impacts surgical outcomes in children with esotropia (ET).

METHODS: A retrospective chart review identified patients who underwent primary bilateral medial rectus (BMR) recessions for ET. Patients were excluded if follow up was ≤2 months. Basic demographic information, visual acuity, stereopsis, alignment, and target angle for surgery was collected. High AC/A was defined as ≥10 prism diopter (Δ) deviation at near compared to distance. Outcome parameters were near and distance deviations ≤10Δ within orthophoria, and/or stereopsis postoperatively. Yates’ continuity correction, unpaired t-test, regression analysis, and one-way ANOVA were used.

RESULTS: We identified 103 patients, 23 with high AC/A and 80 with normal AC/A, preoperatively. Mean age was 4.0 ± 2.5 years. Surgical success measured by postoperative alignment was 48% and 45% in the high AC/A and normal AC/A groups, respectively (p=1.0). There was a statistically significant difference in preoperative near deviation between high AC/A and normal AC/A groups (p=0.0015), however there was no significant difference in preoperative distance deviation (p=0.061). Additionally, there was not a significant difference in preoperative or postoperative stereopsis between high AC/A and normal AC/A groups (p=0.88 and p=0.44, respectively). There was a significant difference in the normal AC/A and high AC/A groups when target angle was directed towards preoperative near deviation as determined by one-way ANOVA (F=170.88, p

CONCLUSIONS: In the setting of ET treated with BMR recession, the presence of high AC/A does not affect surgical success as measured by alignment and stereopsis.


Medicine and Health Sciences