Photorefractive keratectomy and laser in situ keratomileusis in refractive accommodative esotropia.

PURPOSE

To evaluate the efficacy of excimer laser refractive surgery as an alternative for optical correction in patients affected by fully refractive accommodative strabismus.

SETTING

Eye Clinic, University of L'Aquila, L'Aquila, Italy.

METHODS

After a simulation of the cycloplegic correction with contact lenses over a 30-day period, 18 patients (6 men, 12 women, mean age 32.4 years +/- 9.4 [SD]) affected by fully refractive accommodative esotropia had refractive surgery using an excimer laser; 8 patients had photorefractive keratectomy (PRK), and 10 patients had laser in situ keratomileusis (LASIK).

RESULTS

The correction of the refractive error with excimer laser allowed a reduction of the angle of deviation in all but 1 patient, who presented with a regression of refractive error and of the angle of deviation 2 years posttreatment. The 2-year follow-up showed that the mean angle of deviation in PRK was 2(Delta) esophoria at near and 0.4(Delta) esophoria at distance (P<.06); in LASIK, it was 1.7(Delta) esophoria at near and 0.2(Delta) esophoria at distance (P<.06). The difference between the 2 groups was not statistically significant at near (P = .56), at distance (P = .74), or for spherical equivalent (P = .16).

CONCLUSION

Excimer laser refractive surgery seems to be useful in the correction of fully refractive accommodative esotropia.