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Photorefractive keratectomy for the treatment of purely refractive accommodative esotropia: 6 years' experience
  1. A K Hutchinson1,
  2. M Serafino2,
  3. P Nucci2
  1. 1The Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA
  2. 2The Department of Ophthalmology, San Paolo Hospital, University of Milan, Milan, Italy
  1. Correspondence to Dr A K Hutchinson, 1365 Clifton Road, Room B4513, Atlanta, GA 30322, USA; amy.hutchinson{at}


Aims To report the long term outcomes of photorefractive keratectomy (PRK) for the treatment of hyperopia associated with purely refractive accommodative esotropia.

Methods This study was a retrospective chart review of 40 patients aged 17–39 years who underwent PRK to eliminate their dependence on glasses. Pre- and postoperative best spectacle corrected visual acuity (BSCVA), uncorrected visual acuity (UCVA), refractive spherical equivalent (SEQ), ocular alignment and stereoacuity were reviewed.

Results Forty patients (80 eyes) with a mean age of 27.9 years were treated for a mean preoperative SEQ of +3.06 D hyperopia. The mean final postoperative SEQ was +0.06 D. Preoperative BSCVA was 0.04 logarithm of the minimum angle of resolution (logMAR), and did not change postoperatively. Mean UCVA significantly improved from 0.30 logMAR preoperatively to 0.08 logMAR post-operatively. Mean pre-operative esotropia at distance and near was 18.6 prism D. All patients were orthophoric without correction at the 1 month, 1 year and final postoperative evaluations. Visual acuity, refractive error and alignment remained stable after the 1 year postoperative examination. Stereoacuity was unchanged in 80% of patients postoperatively. There were no complications.

Conclusion PRK can be used to treat low to moderate hyperopia associated with purely refractive accommodative esotropia in young adults.

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  • Accepted for presentation at the 35th Annual Meeting of the American Association of Pediatric Ophthalmology and Strabismus, 17–21 April 2009, San Francisco, California, USA.

  • Funding Supported in part by an unrestricted grant to the Emory Eye Center from Research to Prevent Blindness, Inc., New York, USA.

  • Competing interests None declared.

  • Ethics approval Being a retrospective case series, the study was exempt from Institutional review by the University of Milan and received exempt approval from the Emory University School of Medicine Institutional Review Board after being submitted for review. All procedures were carried out in accordance with the declaration of Helsinki.

  • Patient consent Informed consent was obtained from the patients (and, in the case of one minor child, his parents), acknowledging that the intended result of treatment was to correct both hyperopia and esotropia.

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

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