Photorefractive keratectomy followed by strabismus surgery for the treatment of partly accommodative esotropia.
OBJECTIVE
To evaluate photorefractive keratectomy (PRK) followed by bilateral medial rectus muscle recessions (BMR) to treat adults with partly accommodative esotropia.


METHODS
We reviewed medical records of 10 consecutive patients with partly accommodative esotropia who underwent PRK to correct hyperopia followed 6 months later by BMR to treat the accommodative and nonaccommodative components of their esotropia, respectively. Visual acuity, spherical equivalent of refractive error, alignment, and sensory data were collected and analyzed.


RESULTS
Twenty eyes of 10 patients were treated and followed for 1 year. PRK was successful in treating the hyperopia (mean post-PRK spherical equivalent was 0.14 D (SD = 0.22)) and the accommodative portion of the esotropia (the mean percentage of the distance accommodative component eliminated by PRK was 101.67% and the mean percentage of the near accommodative component eliminated by PRK was 115%). However, subsequent BMR using standard surgical tables based on the distance deviation to treat the post-PRK residual (nonaccommodative) esotropia resulted in uniform undercorrection.


CONCLUSIONS
PRK may be useful to treat the accommodative portion of partly accommodative esotropia. Bilateral medial rectus muscle recession can be used to treat the residual, nonaccommodative component; however, it may be necessary to base the surgical dosage on the near deviation.
Nucci
Paolo
P
Department of Ophthalmology, San Paolo Hospital, University of Milan, Italy.
Serafino
Massimiliano
M
Hutchinson
Amy K
AK
D000065:Accommodation, Ocular; D000328:Adult; D003315:Cornea / Q000601:surgery*; D004948:Esotropia / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D006956:Hyperopia / Q000150:complications / Q000601:surgery*; D054018:Lasers, Excimer; D008297:Male; D009801:Oculomotor Muscles / Q000601:surgery*; D018903:Photorefractive Keratectomy / Q000379:methods*; D012029:Refraction, Ocular; D012189:Retrospective Studies; D015348:Vision, Binocular; D014792:Visual Acuity