Photorefractive keratectomy and laser in situ keratomileusis in refractive accommodative esotropia

PURPOSE: To evaluate the efficacy of excimer laser refractive surgery as an alternative for optical correction in patients affected by fully refractive accommodative strabismus. SETTING: Eye Clinic, University of L'Aquila, L'Aquila, Italy. METHODS: After a simulation of the cycloplegic correction with contact lenses over a 30-day period, 18 patients (6 men, 12 women, mean age 32.4 years +/- 9.4 [SD]) affected by fully refractive accommodative esotropia had refractive surgery using an excimer laser; 8 patients had photorefractive keratectomy (PRK), and 10 patients had laser in situ keratomileusis (LASIK). RESULTS: The correction of the refractive error with excimer laser allowed a reduction of the angle of deviation in all but 1 patient, who presented with a regression of refractive error and of the angle of deviation 2 years posttreatment. The 2-year follow-up showed that the mean angle of deviation in PRK was 2(Delta) esophoria at near and 0.4(Delta) esophoria at distance (P<.06); in LASIK, it was 1.7(Delta) esophoria at near and 0.2(Delta) esophoria at distance (P<.06). The difference between the 2 groups was not statistically significant at near (P = .56), at distance (P = .74), or for spherical equivalent (P = .16). CONCLUSION: Excimer laser refractive surgery seems to be useful in the correction of fully refractive accommodative esotropia.