To compare the clinical outcomes of patients with an esotropia with an accommodative component after infantile esotropia surgery and patients with primary refractive accommodative esotropia.The medical records of patients with postoperative (secondary group) and primary refractive accommodative esotropia (primary group) were reviewed retrospectively. Changes in ocular alignment, refractive error, weaning rate, decompensation rate over time, and sensory outcomes were compared.The overall change in ocular deviation with glasses correction was -0.5Δ/year in the secondary group and -0.2Δ/year in the primary group (P = 0.010). The overall change in spherical equivalent refractive error was -0.2 D/year in the secondary group and -0.3 D/year in the primary group (P < 0.001). The latest stereoacuity result was poorer in the secondary group than in the primary group (P = 0.027). No significant differences in the decompensation or weaning rates were detected between groups.The changes in refractive error and the amount of esotropia over time were different between the secondary group and the primary group. Although refractive error was significantly lower and stereoacuity was poorer in the secondary group compared to the primary group, the majority of patients in the secondary group maintained good control of ocular alignment after hyperopic correction.