Article Text

PDF
Refractive surgery in patients with accommodative and non-accommodative strabismus: 1-year prospective follow-up
  1. Caitriona Kirwan1,2,
  2. Michael O'Keefe1,2,
  3. Gillian M O'Mullane2,3,
  4. Clare Sheehan2,3
  1. 1Refractive Surgery Department, The Mater Private Hospital, Dublin, Ireland
  2. 2Ophthalmology Department,The Children's University Hospital, Dublin, Ireland
  3. 3Orthoptic Department, Institute of Ophthalmology, Dublin, Ireland
  1. Correspondence to Professor Michael O'Keefe, Suite 5, Mater Private Hospital, Eccles Street, Dublin 7, Ireland; mokeefe{at}materprivate.ie

Abstract

Aim To determine the efficacy and safety of keratorefractive surgery in patients with accommodative and non-accommodative strabismus in a prospective study.

Methods Preoperative assessment included uncorrected (UCVA) and best-corrected visual acuity (BCVA), manifest and cycloplegic refraction and orthoptic examination. Laser in situ keratomileusis, laser epithelial keratomileusis and Artisan phakic intraocular lens implantation were performed. All treated eyes had a BCVA of at least 6/18 preoperatively. One year postoperatively, visual acuity, refractive error and ocular alignment were reassessed.

Results 28 patients (nine male, 19 female) of mean age 33.0±10.0 years (range 20–59) were included in the study. Esotropia was present in 16 patients; nine fully accommodative, three partially accommodative and four non-accommodative. Twelve patients had exodeviations; 10 exotropia and two exophoria and a history of strabismus surgery. Excellent visual and refractive outcomes were obtained postoperatively. There was no loss, and one eye gained a line of BCVA. Fully accommodative esotropes attained orthophoria or microtropia. Improved ocular alignment occurred in partially accommodative esotropes and myopic exotropes. No patient experienced decompensation of strabismus or diplopia.

Conclusions Refractive surgery may be performed successfully in patients with accommodative and non-accommodative strabismus. However, great care must be taken when determining patient suitability. This is of particular importance in young hyperopic patients to prevent decompensation of ocular alignment over time.

  • Esotropia
  • exotropia
  • accommodative
  • LASIK
  • LASEK
  • treatment surgery

Statistics from Altmetric.com

Footnotes

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the Review Board of the Mater Private Hospital, Eccles Street, Dublin.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.