Hyperopic laser in situ keratomileusis for refractive accommodative esotropia.

Area of Science:

• Ophthalmology
• Refractive Surgery
• Strabismus Management

Background:

• Refractive accommodative esotropia (RAE) is a form of inward eye turning linked to farsightedness.
• Traditional management often involves glasses or eye muscle surgery.
• Hyperopic LASIK offers a potential alternative for correcting the underlying refractive error.

Purpose of the Study:

• To evaluate the effectiveness of hyperopic laser in situ keratomileusis (LASIK) in adult patients with RAE.
• To determine if hyperopic LASIK can achieve orthophoria (aligned eyes) without the need for optical correction.
• To assess the safety and visual outcomes of this surgical approach.

Main Methods:

• A prospective single-center clinical trial involving 9 eyes from 18 adult patients with RAE.
• Patients underwent hyperopic LASIK, with astigmatism managed by steepening the flattest meridian.
• Mean follow-up was 20 months, with pre-operative refraction averaging +5.01 D and deviation of 36 prism diopters.

Main Results:

• Immediate and sustained orthophoria was achieved in all patients post-surgery.
• 56% of eyes were within +/-0.5 D and 89% within +/-1.0 D of emmetropia.
• Uncorrected visual acuity significantly improved (P <.005), especially for near vision; best corrected visual acuity was maintained, with no major complications.

Conclusions:

• Hyperopic LASIK is a safe and effective treatment for correcting refractive error and esodeviation in adult RAE patients.
• The procedure successfully created orthophoria without optical correction.
• Further research is needed to explore its application in younger patient populations.