Magli Adriano, Iovine Antonello, Gagliardi Vincenzo, Fimiani Francesco, Nucci Paolo
Department of Ophthalmology, University of Napoli "Federico II", Napoli - Italy.
Eur J Ophthalmol. 2009 Mar-Apr;19(2):188-95. doi: 10.1177/112067210901900203.
To evaluate the clinical results obtained with excimer laser treatment of fully refractive accommodative esotropia.
Fully refractive accommodative esotropia was corrected in 17 patients with laser in situ keratomileusis (LASIK) and in 3 patients with photorefractive keratectomy (PRK). The mean age of the patients at time of refractive surgery was 18.8 years (range 14 to 24 years). All surgical procedures were performed under local anesthesia. The preoperative and postoperative data were retrospectively analyzed with regards to visual acuity, ocular alignment, and stereopsis.
The mean preoperative deviation without correction was 18.1Delta for near vision and 13.7Delta for distance vision. After refractive surgery the mean postoperative deviation was 4Delta esophoria at near, and 2.5Delta of esophoria at distance: 10 patients (50%) showed esophoria for both distance and near vision, 2 patients (10%) esophoria only for near vision, and 8 patients (40%) orthophoria for both distance and near vision. Emmetropia (-/+1.00 D) was obtained in 97.5% of eyes (39 of 40). The mean correction obtained with excimer laser was +4.62 D(range +2.25 to +7.75, SD 4.52). The preoperative BSCVA was in all eyes greater than or equal to 20/30. There were no significant differences observed between the preoperative and postoperative mean best-corrected visual acuity (p=0.32). There were no complications. The follow-up period lasted a mean of 30.2 months.
The treatment of fully refractive accommodative esotropia with excimer laser was found effective and safe, even in young or adolescent patients. More studies are needed to increase the patient experience and extend the follow-up period in order to evaluate the stability of these results over time.
评估准分子激光治疗完全屈光性调节性内斜视的临床效果。
17例患者采用准分子原位角膜磨镶术（LASIK）、3例患者采用准分子激光角膜切削术（PRK）矫正完全屈光性调节性内斜视。屈光手术时患者的平均年龄为18.8岁（范围14至24岁）。所有手术均在局部麻醉下进行。对术前和术后的视力、眼位及立体视数据进行回顾性分析。
术前未矫正时近视力平均斜视度为18.1三棱镜度，远视力平均斜视度为13.7三棱镜度。屈光手术后近视力平均术后斜视度为4三棱镜度内隐斜，远视力平均为2.5三棱镜度内隐斜：10例患者（50%）远近视力均为内隐斜，2例患者（10%）仅近视力为内隐斜，8例患者（40%）远近视力均为正位。97.5%的眼（40只眼中的39只）达到正视（-/+1.00 D）。准分子激光平均矫正量为+4.62 D（范围+2.25至+7.75，标准差4.52）。所有眼术前最佳矫正视力均大于或等于20/30。术前和术后平均最佳矫正视力之间未观察到显著差异（p = 0.32）。无并发症发生。随访期平均持续30.2个月。
即使对于年轻或青少年患者，准分子激光治疗完全屈光性调节性内斜视也被发现是有效且安全的。需要更多研究以增加患者体验并延长随访期，从而评估这些结果随时间的稳定性。
