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Michela Fresina, Giuseppe Giannaccare, Laura Primavera, Piera Versura, Emilio C Campos; Modification of the angle of strabismus in hyperopic patients after photorefractive keratectomy. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2924.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate refractive, binocular vision and ocular alignment outcomes of photorefractive keratectomy (PRK) for the treatment of hyperopia in esotropic patients.
Medical charts of hyperopic patients presenting full or partial accommodative esotropia (FAE and PAE) undergone PRK from 2011 to 2014 were reviewed. History of strabismus including previous surgery was collected. The primary outcome was to assess the role of PRK in improving ocular alignment. The secondary outcomes were the assessments of uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), spherical equivalent (SE) and stereoacuity.
Thirty-two hyperopic patients were included. Three patients with FAE underwent only PRK. Of twenty-nine patients with PAE, four patients underwent only PRK while twenty-five underwent PRK and strabismus surgery. Five patients presented secondary exotropia at the time of PRK. The mean corrected esodeviation significantly decreased after PRK in the overall esotropic group (p=0.03), and in particular in the group with small-angle esodeviation (<20PD) (p=0.029). Conversely, the mean corrected exodeviation did not significantly decrease (p=0.37). The mean pre operative BCVA and post-operative UCVA did not differ (p=0.13) while the mean post-operative SE decreased significantly after PRK (p<0.0001).
Our study confirmed that PRK eliminates the accommodative component of the deviation. Further, this procedure reduced or eliminated also the non-accommodative component of esodeviation, especially for small-angles. This finding could influence the timing of refractive and strabismus surgeries, avoiding the latter procedure in case of small-angle esodeviation before PRK.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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