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

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.