Comparison of bifoveal fusion recovery efficiency using synoptophore and the liquid crystal glasses in children operated for esotropia

Purpose. This study aims to analyze sensory fusion recovery using method of  LCD glasses with  alternating occlusion of  visual  fields  and compare its efficacy with orthoptic treatment using synoptophore. Material  and methods. Eighty-six  patients  with  prior  esotropia, post-operative absence of bifoveal fusion and residual angle of deviation <10° were studied. All patients were hyperopic. All of them underwent synoptophore treatment for 12 months (3–4 courses). Forty-three patients unsuccessful in bifoveal fusion recovery underwent treatment with LCD glasses for 6 hours/day. Results. Bifoveal fusion and binocular vision were significantly more often recovered (P<0,000) by LCD glasses treatment as compared to the synoptofore treatment. The stable bifoveal fusion was formed in 29 (67%) and 16 (18%) children, the unstable one –  in 11 (26%) and 17 (20%); the treatment was ineffective  in 3  (7%) and 53  (62%) patients,  respectively. Binocular vision was obtained in 20 (46%) and 21 (24%) patients, and taking into account the subsequent diplopic treatment in cases with stable sensory fusion in 10 (23%) and 2 (2%), respectively. Parents were more satisfied with the treatment by LCD glasses because of the lack of frequent visits to the hospital. Conclusion. Alternating occlusion of visual fields with LCD glasses is a more effective mean of bifoveal fusion and binocular vision recovery than orthoptic treatment with a synoptophore in patients after successful strabismus surgery.