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

Purpose: To evaluate the efficacy and safety of laser in situ keratomileusis (LASIK) in partially refractive accommodative esotropia (pRAE) and fully refractive accommodative esotropia (fRAE).

Methods: 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.

Results: 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.

Conclusions: 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.