Photorefractive keratectomy on purely refractive accommodative esotropia

Area of Science:

• Ophthalmology
• Refractive Surgery
• Pediatric Ophthalmology

Background:

• Accommodative esotropia is a condition where the eyes turn inward due to focusing effort, often associated with hyperopia.
• Refractive surgery, specifically PRK, is explored as a treatment for this specific type of strabismus in young patients.

Purpose of the Study:

• To evaluate the efficacy and outcomes of photorefractive keratectomy (PRK) in treating young adults with purely refractive accommodative esotropia.
• To assess changes in visual acuity, ocular alignment, and refractive error following PRK.

Main Methods:

• A prospective study involving 10 patients (20 eyes) with accommodative hyperopic esotropia.
• Pre-operative and post-operative assessments included visual acuity (BCVA, UCVA), ocular alignment, stereopsis, keratometry, pachymetry, and corneal topography over 24 months.
• Paired t-student statistical analysis was employed.

Main Results:

• Significant improvements in uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA) were observed two years post-PRK.
• Pre-operative mean spherical equivalent of +3.92 D was corrected to 0 D by two years post-surgery.
• All patients achieved orthophoria without correction, and stereopsis remained unaffected.

Conclusions:

• Photorefractive keratectomy is a safe and effective two-year treatment for esotropia linked to mild to moderate hyperopia in young adults.
• PRK offers a viable surgical option for managing purely refractive accommodative esotropia, improving both visual function and alignment.