Effect of hyperopic laser in situ keratomileusis on ocular alignment and stereopsis in patients with accommodative esotropia.
OBJECTIVE
To evaluate the effect of laser in situ keratomileusis (LASIK) on ocular alignment and stereopsis in patients with accommodative esotropia.


METHODS
Retrospective, non-comparative, interventional case series.


METHODS
Since 1998, 27 patients (mean age, 33.3 years; range, 10-52 years) with comitant esophoria or esotropia and hyperopia meeting eligibility requirements underwent bilateral LASIK for correction of refractive error.


METHODS
Bilateral hyperopic LASIK was performed using the Technolas Keracor 217 excimer laser (Bausch & Lomb) in 22 patients and using the Nidek 5000 excimer laser in 5 patients.


METHODS
Visual acuity (best-corrected and uncorrected), refractive error, ocular alignment, and stereopsis were recorded before and after LASIK. Log transformation of each visual acuity was done before data analysis.


RESULTS
Using paired t tests, the mean uncorrected esotropia was significantly reduced from 9.0 prism diopters (PD) (range, 0 [esophoria only] to 20 PD; standard deviation [SD], 7.39) before surgery to 3.3 PD (range, 0-15 PD; SD, 6.20) after surgery (P < 0.0001). Most patients (14 patients, 58%) had a reduction in esodeviation after LASIK, but 10 patients (42%) had no response to surgery, and these patients could not be predicted on the basis of preoperative sensorimotor testing. No patient had a worsening sensorimotor status after LASIK. Nine patients subsequently underwent conventional eye muscle surgery.


CONCLUSIONS
Hyperopic LASIK was effective in reducing the mean uncorrected esotropia in this group of patients. However, accurately determining those patients most likely to benefit from the procedure was difficult.
Stidham
D Brian
DB
Department of Ophthalmology and Visual Sciences, The University of Texas-Houston Medical School, Houston, Texas, USA.
Borissova
Oksana
O
Borissov
Valeri
V
Prager
Thomas C
TC
D000065:Accommodation, Ocular; D000293:Adolescent; D000328:Adult; D002648:Child; D003867:Depth Perception / Q000502:physiology*; D004948:Esotropia / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D006956:Hyperopia / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D020731:Keratomileusis, Laser In Situ; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000503:physiopathology*; D012189:Retrospective Studies; D015348:Vision, Binocular; D014792:Visual Acuity