Medial rectu pulley poterior fixation i a effective a cleral poterior fixation for acquired eotropia with a high AC/A ratio

Purpoe To compare traditional medial rectu (MR) cleral poterior fixation veru MR pulley poterior fixation without cleral uture for the treatment of acquired eotropia (ET) with a high accommodative convergence over accommodation (AC/A) ratio. Deign Nonrandomized interventional cae erie. Method Medical record were retropectively reviewed for twenty–two patient who underwent bilateral MR poterior fixation for acquired ET with a high AC/A ratio, with or without aociated MR receion. The main outcome meaure wa the reduction in ditance-near diparity created by MR cleral poterior fixation compared with MR pulley poterior fixation. Reult Nine patient underwent MR cleral poterior fixation urgery, even in combination with MR receion for ditance ET. Potoperatively, the ditance-near diparity decreaed an average of 11.8 prim diopter, tereoacuity improved in ix patient, and eight patient no longer needed bifocal. Thirteen patient underwent MR pulley poterior fixation urgery, 10 in combination with MR receion for ditance ET. Potoperatively the ditance-near diparity decreaed an average of 14.4 prim diopter, tereoacuity improved in eight patient, and 12 patient no longer required bifocal. tatitically, the two procedure were equivalent. One patient in each group wa undercorrected at near only, with the reidual near ET controlled with bifocal. One patient who underwent MR pulley poterior fixation combined with large MR receion wa overcorrected at ditance only. Concluion Traditional MR cleral poterior fixation and MR pulley poterior fixation are equally effective in treating acquired ET with a high AC/A ratio.