Refractive surgery for accommodative esotropia in special needs children and adolescents

Session Details

Session Title: Hyperopic corrections

Session Date/Time: Sunday 14/09/2014 | 16:30-18:00

Paper Time: 17:06

Venue: Boulevard B

First Author: : M.Kamel SAUDI ARABIA

Co Author(s): :                  

Abstract Details

Purpose:

we analyze outcomes in a sizeable number of children and adolescents treated using the excimer laser or phakic intraocular lenses.

Setting:

Magrabi Hospital Aseer

Methods:

Clinical outcome data were collated prospectively in 54 children and adolescents (108 eyes) treated for hyperopia using excimer laser keratectomy or implantation of phakic IOLs. All children had esotropia; fully accommodative (21 children) or partially accommodative/mixed mechanism (33 children) and difficulties with spectacle or contact lens wear. Mean age at refractive surgery was 10.2 yrs (range 3 to 18 years); mean follow-up was 2.9 yrs.

Results:

: Spherical refractive error averaged 4.86 D (range +2.25 to +6.75) in children treated using excimer laser and +9.25 (range +6.75 to +11.5) in those treated by IOL implantation. 90/108 eyes (83%) were corrected to within +/- 1.0 D of target refractive error and all to within 1.5 D. Best-corrected and uncorrected visual acuity improved 0.12 logMAR and 0.58 logMAR respectively. Pre-operative esotropia averaged 6.1 PD wearing refractive correction and 24.4 D not wearing correction. Esotropia after refractive surgery (not wearing correction) was reduced to an average 8.3 D. During the follow-up period 15% (8 children) required strabismus re-operation.

Conclusions:

Refractive surgery for hyperopia reduces substantially the angle of accommodative esotropia in children who have difficulties with spectacle or contacts lens wear. Longer term follow-up will reveal whether refractive regression promotes recurrence of larger heteroptropia. Excimer laser keratectomy or phakic IOL implantation are unusual but useful treatment alternatives for accommodative esotropia in a subpopulation of special needs strabismic children

Financial Interest:

NONE