Laser in situ keratomileusis for treatment of fully or partially refractive accommodative esotropia

To evaluate the efficacy and safety of laser in situ keratomileusis (LASIK) in partially refractive accommodative esotropia (pRAE) and fully refractive accommodative esotropia (fRAE). Forty-two eyes of 21 patients who had LASIK for correcting hyperopic refractive error were evaluated. Refractive errors, uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA), ocular alignment, and stereopsis were recorded before and after LASIK. Sixteen patients with fRAE and 5 with pRAE were evaluated. Mean age at the time of surgery was 19.00+/-3.79 years. Mean follow-up time was 12.19+/-4.51 months. For the fRAE group, the mean preoperative angle of deviation without spectacle correction was +19.13+/-5.87 prism diopters (PD); all were orthophoric with spectacles. Postoperatively, all these patients achieved less than 10 PD of deviation without spectacles. For the pRAE group, the mean preoperative angle of deviation was +32.60+/-9.81 PD and +14.60+/-6.14 PD without and with spectacles, respectively. Postoperatively, the mean angle of deviation was +13.60+/-5.72 PD and +12.80+/-5.40 PD without and with spectacles, respectively. For all 21 patients, the preoperative mean spherical equivalent (SE) with cycloplegia was +4.94+/-1.43 diopters (D); it was +1.49D+/-0.70 D postoperatively. Three eyes lost 1 line of BCVA and 3 eyes gained 1 line. No intraoperative complication was recorded. LASIK is a safe and effective method for treating refractive error and creating orthophoria in fRAE. In pRAE, it eliminates the refractive component of deviation safely and effectively.