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Accommodative Esotropia Treatment Plan Utilizing Simultaneous Strabismus Surgery and Photorefractive Keratectomy
H Sprague Eustis1, Pulin Shah1
1Department of Ophthalmology, Ochsner Clinic Foundation, New Orleans, Louisiana.
American Journal of Ophthalmology
|January 18, 2018
Summary
This study shows that combining photorefractive keratectomy (PRK) with strabismus surgery effectively treats accommodative esotropia, leading to good vision and eliminating the need for glasses.
Area of Science:
- Ophthalmology
- Surgical Procedures
- Vision Correction
Background:
- Accommodative esotropia is a common acquired condition.
- Pathogenesis often involves hyperopia and high accommodative convergence/accommodation ratio or tight medial recti.
Purpose of the Study:
- To review an individualized treatment plan for accommodative esotropia.
- To assess the combination of photorefractive keratectomy (PRK) and strabismus surgery.
Main Methods:
- Retrospective review of 15 patients (ages 11-19) with accommodative esotropia.
- Treatment included PRK and strabismus surgery (11 patients) or PRK alone (4 patients).
- Goals: physiologic refractive error, good visual acuity (VA), and straight eyes without correction.
Main Results:
- All patients were spectacle-free at 6-month follow-up.
- Good VA was maintained in most eyes; alignment within ±10 prism diopters in 13/15 patients.
- Refractive outcomes showed a significant percentage within 1-2 diopters of target for sphere and astigmatism.
Conclusions:
- Simultaneous PRK and strabismus surgery is safe and effective for accommodative esotropia.
- An individualized approach can achieve physiologic refractive error, good VA, and spectacle independence.
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