Hyperopic laser in situ keratomileusis for refractive accommodative esotropia.
OBJECTIVE
To assess the efficacy of hyperopic laser in situ keratomileusis (LASIK) in creating orthophoria without optical correction in adult patients with refractive accommodative esotropia (RAE).


METHODS
Instituto Oftalmológico de Sabadell, Sabadell, Barcelona, Spain.


METHODS
This prospective single-center clinical trial studied 9 eyes (18 patients) with RAE having hyperopic LASIK. The mean follow-up was 20 months (range 12 to 24 months). The mean preoperative refraction was +5.01 diopters (D) and the mean deviation angle without optical correction, 36 prism diopters. The intervention was hyperopic LASIK using the Automated Corneal Shaper microkeratome (Bausch & Lomb) and the Apollo broad-beam excimer laser using a 5.5 mm optical zone and an 8.0 mm transition zone; astigmatism was treated by steepening the flattest meridian.


RESULTS
All patients achieved orthophoria or the preoperative microtropia without optical correction immediately after surgery. This was maintained throughout the follow-up. Fifty-six percent of all cases were within +/-0.5 D of emmetropia, and 89% were within +/-1.0 D. The uncorrected visual acuity improved significantly (P <.005), especially at near, and the mean best corrected visual acuity (BCVA) was maintained, although 4 eyes (22%) lost 1 line of BCVA. There were no significant complications.


CONCLUSIONS
In adult patients with RAE, treatment of the refractive error using hyperopic LASIK was safe and effective and corrected the esodeviation. Further studies in younger patients will help determine the age at which this intervention may be indicated.
Hoyos
Jairo E
JE
Instituto Oftalmológico Hoyos, Barcelona, Spain. jairoca@intercom.es
Cigales
Melania
M
Hoyos-Chacón
Jairo
J
Ferrer
Jorge
J
Maldonado-Bas
Arturo
A
D000065:Accommodation, Ocular; D000328:Adult; D019781:Corneal Topography; D004948:Esotropia / Q000503:physiopathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D006956:Hyperopia / Q000503:physiopathology / Q000601:surgery*; D020731:Keratomileusis, Laser In Situ; D008297:Male; D011446:Prospective Studies; D012029:Refraction, Ocular; D014792:Visual Acuity