Photorefractive Keratectomy for the Treatment of Purely Refractive Accommodative Esotropia: Six Year Experience

• Type of Material: Article
• Authors: Amy K Hutchinson, Emory University; Massimiliano Serafino, University of Milan; Paolo Nucci, University of Milan
• Language: English
• Date: 2010-02
• Publisher: BMJ Publishing Group
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2010, British Medical Journal Publishing Group
• Final Published Version (URL): http://bjo.bmj.com/content/94/2/236
• Title of Journal or Parent Work: British Journal of Ophthalmology
• ISSN: 0007-1161
• Volume: 94
• Issue: 2
• Start Page: 236
• End Page: 240
• Grant/Funding Information: Supported in part by an unrestricted grant to the Emory Eye Center from Research to Prevent Blindness, Inc., New York, New York.; National Eye Institute : NEI
• Keywords: hyperopia; refractive surgery; photorefractive keratectomy; accommodative esotropia
• Research Categories: Health Sciences, Opthamology

Abstract

Background/aims To report the long term outcomes of photorefractive keratectomy (PRK) for the treatment of hyperopia associated with purely refractive accommodative esotropia. Methods Retrospective chart review of 40 patients age 17–39 who underwent PRK to eliminate their dependence on glasses. Pre and post-operative best spectacle corrected visual acuity (BSCVA), uncorrected visual acuity (UCVA), refractive spherical equivalent (SEQ), ocular alignment, and stereoacuity were reviewed. Results Forty patients (80 eyes) with mean age 27.9 years were treated for a mean pre-operative SEQ of +3.06D hyperopia. The mean final post-operative SEQ was +0.06. Pre-operative BSCVA was 0.04 logMAR, and did not change post-operatively. Mean UCVA significantly improved from 0.30 logMAR preoperatively to 0.08 logMAR post-operatively. Mean pre-operative esotropia at distance and near was 18.6 PD. All patients were orthophoric without correction at the one month, one year, and final post-operative evaluations. Visual acuity, refractive error and alignment remained stable after the one year post-operative examination. Stereoacuity was unchanged in 80% of patients postoperatively. There were no complications. Conclusion PRK can be used to treat low to moderate hyperopia associated with purely refractive accommodative esotropia in young adults.