Effectiveness of prismatic combination treatment on children with amblyopia combined with esotropia

Abstract

Purpose Prism has been used as a non-surgical treatment for certain types of strabismus; however, its role as the primary intervention for amblyopia combined with esotropia has been rarely studied. The objective of this study was to compare the effectiveness of prismatic correction with traditional occlusion therapy in treating amblyopia combined with esotropia. Methods This retrospective case-control study included children aged 3 to 16 years with amblyopia combined with esotropia. After refractive correction, the patients were divided into two groups. The control group received traditional occlusion therapy combined with binocular treatment, while the prism group received full correct prisms combined with binocular treatment. Clinical characteristics, visual acuity, binocular functions, and the angle of esodeviation were assessed at each follow-up examination. The treatment outcomes after 12 months were evaluated to determine the more effective protocol. Results At baseline, there were no significant differences in age, gender ratio, best-corrected visual acuity (BCVA) of the amblyopic eye, deviation amount (△), and binocular vision function between the two groups (all P > 0.05). After treatment, both groups showed improvement in amblyopic eye visual acuity. The difference in visual acuity improvement between the two groups was not statistically significant at 6 months (0.18±0.17 vs 0.14±0.11, P > 0.05), but it was statistically significant at 12 months (0.35±0.20 vs 0.25±0.18, P < 0.05). The prism group demonstrated a significant improvement in binocular vision function, whereas there was no significant change in the control group at 6 months or 12 months after treatment. The deviation amount (△) remained stable in both groups, with no significant difference between the two groups after treatment. Conclusion Prismatic treatment combined with binocular treatment was more effective in improving amblyopic eye visual acuity and binocular vision compared to traditional occlusion therapy combined with binocular treatment in children with amblyopia combined with esotropia. Prismatic correction could be considered as the first-line treatment for amblyopia combined with esotropia.