Article
Laser subepithelial keratomileusis for the correction of hyperopia in young patients with refractive accommodative esotropia
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Authors
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J. Rehurek
- Department of Ophthalmology, Masaryk University Hospital, Brno, Czech Republic
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R. Autrata
- Department of Ophthalmology, Masaryk University Hospital, Brno, Czech Republic
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K. Vodicková
- Department of Ophthalmology, Masaryk University Hospital, Brno, Czech Republic
| Published: | September 22, 2004 |
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Outline
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Objective
To evaluate the efficacy and safety of the laser assisted subepithelial keratomileusis (LASEK) for correction of hyperopia in young patients with refractive accomodative esotropia, as alternative to conventional optical correction by glasses or contact lenses.
Methods
This prospective study analyzed refractive results, ocular alignment, binocular vision outcome in 19 patients (38 eyes) with the "pure" refractive accommodative esotropia, who underwent hyperopic LASEK. The mean age of patients was 22±6.4 years (range 15 to 33 years). The mean follow-up was 27 months ( range,12 to 38 months). The mean preoperative spherical equivalent (SE) refraction was +4.59 diopters (D) (range, +2.75 to + 5.5 D). The mean angle of esodevation without optical correction was 43 prism diopters (PD), (range, 25 to 60 PD). Hyperopic LASEK was performed by the Nidek EC 5000 slit scanning excimer laser using a 5.5mm optical zone and 9.0 mm transition zone.
Results
The mean postoperative SE refraction at last examination was + 0.41 ±0.62D (range -0.5 to +1.5). Sixteen eyes (42%) were within ±0.50 D and 32 eyes (83%) were within ±1.00 D of emmetropia. The mean best -spectacle corrected visual acuity (BSCVA) and binocular vision quality were saved or improved. No eye lost 1 or more Snellen line of BSCVA. Preoperatively, the mean uncorrected visual acuity was 0.52 ±0.27 for distance and increased to the mean value of 0.79 ±0.17 at the last assessment. The mean postoperative angle of esodeviation was 4.1 ±4.5 PD (range 0 to 15 PD), (P<0.05). At 1 year after surgery, 14 patients (74%) had orthophoria or the same microesotropia they had with optical correction before surgery. Five patients (26%) had undercorrection, and they required additional spectacle correction to achieve a stabile ortophoria. There were no serious complications.
Conclusions
Hyperopic LASEK was an efective and safe laser surgical technique for the correction of the refractive error and for the improvement of the esodeviation angle in refractive accomodative esotropia.
