First Author: O.Klokova RUSSIA
Co Author(s): S. Sakhnov A. Zabolotny
Purpose:
Estimation of anatomic and functional results of LASIK at medium and high degree hypermetropy correction with complicated astigmatism at patients with convergent accommodative strabismus.
Setting:
: Krasnodar Branch The academician S.N. Fedorov FSBI «IRTC «Eye Microsurgery» Ministry of public health of Russian Federation
Methods:
In research group was 9 patients (18 eyes) at the age of 28.5±1.77 (19 to 44). Follow-up was not less than 6 months. Average spherical component before LASIK was +4.8±0.52 D (+2.5 to +8.0 D), average cylindrical component was +1.46±0.28 D (+0.75 to +3.5 D), average difference between manifest refraction and on the back of cycloplegia was +1.58±0.29 D (+0.5 to +3.5 D). LASIK parameters consideration was carried out regarding to hypermetropy facts got on the back of cycloplegia. Deviation angle inside at close and far distance was not differ, without spectacle correction was 10.1±0.75º (5ºto 15º), in spectacles – 0º. LASIK were carried out using microkeratom Evolution 3Е (Moria, France) and ALLEGRETTO WAVE EYE-Q 400 Hz (NOVARTIS/ALCON, Switzerland). Last years it was determined that with decrease of eyeball sagittal size deviation of visual axis across increased (р<0.01). It is necessary to consider size of eyeball visual axis deviation in accordance with its anatomic axis when choosing type of excimer laser surgery. In 8 cases (44.4 %) significant displacement of eyeball optical axis towards to pupil center surgery was carried out according to T- CAT technology based on keratotopography data and Kappa angle.
Results:
On the run of surgical attack and postoperative period there were no complications. For 7 (77.7 %) patient we reached orthophoria without correction and was stable during observation time. In 1 case it was need operation for treatment of residual deviation angle 10º (before operation 15º), in other case patient had hypermetropy +8,0D before correction, imputed hypo effect was 1.5 D; residual inconstant deviation 2-3º (preoperative meaning 12º).
At 16 eyes (88.9%) postoperative refraction was ±1.0 D. Refraction normalized to 3rd month after operation. First 2 months refractive hyper effect from 0.5 till 1.5 D was marked at 3 patients. There were no reoperations in any case. Average regress of hypermetropy was 0.76±0.2 D, spherical component +0.5±0.17 D, cylindrical component – 0.79±0.2 D. UCVA was normalizing some months and reached preoperative BCVA level (0.84±0.22) up to 6th month. At 3 cases (16.7%) BCVA surpassed preoperative meanings over 0.1 – 0.2, in other cases without changes.
Conclusions:
Analysis of findings allows viewing excimer laser correction of convergent accommodative strabismus refractive component according to LASIK technology as pathogenetically oriented, effective, safe method and alternative to traditional treatment of such form of strabismus. For estimation of correlation between functional results after LASIK and stability of deviation disposal we are carrying out further researches.
Financial Disclosure:
None
