1
|
MacNeill K, Jindani Y, Patil N, Solish D, Gelkopf MJ, Sabri K. Refractive surgery as a treatment tool for strabismus: systematic review. J Cataract Refract Surg 2023; 49:1061-1067. [PMID: 37144642 DOI: 10.1097/j.jcrs.0000000000001213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 04/28/2023] [Indexed: 05/06/2023]
Abstract
The impact refractive surgery has on preoperative horizontal strabismus is rapidly evolving, and this knowledge can provide valuable clinical context when considering refractive surgery as a treatment for strabismus. 515 studies were identified, of which 26 met the inclusion criteria. Analysis indicated that refractive surgery resulted in an overall decrease in the mean uncorrected postoperative angle of deviation caused partially or fully due to refractive error and highlighted the varied outcome of refractive surgery on nonaccommodative horizontal strabismus with limited evidence to suggest refractive surgery for this type of strabismus. Efficacy of refractive surgery in reducing concomitant horizontal strabismus depends on several factors: type of horizontal ocular deviation, patient age, and extent of refractive error. Refractive surgery can be an effective treatment for refractive accommodative horizontal strabismus in patients with stable, mild to moderate myopia or hyperopia and should be considered with careful patient selection for optimum outcome.
Collapse
Affiliation(s)
- Katelyn MacNeill
- From the Division of Ophthalmology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada (MacNeill, Jindani, Sabri); Michael DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada (Patil); School of Medicine, Queen's University, Kingston, Ontario, Canada (Solish, Gelkopf)
| | | | | | | | | | | |
Collapse
|
2
|
García‐Montero M, Albarrán Diego C, Garzón‐Jiménez N, Pérez‐Cambrodí RJ, López‐Artero E, Ondategui‐Parra JC. Binocular vision alterations after refractive and cataract surgery: a review. Acta Ophthalmol 2019; 97:e145-e155. [PMID: 30218490 DOI: 10.1111/aos.13891] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 07/18/2018] [Indexed: 11/29/2022]
Abstract
To review binocular and accommodative disorders documented after corneal or intraocular refractive surgery, in normal healthy prepresbyopic patients. A bibliographic revision was performed; it included works published before 1st July 2017 where accommodation and/or binocularity was assessed following any type of refractive surgical procedure. The search in Pubmed yielded 1273 papers, 95 of which fulfilled the inclusion criteria. Few publications reporting binocular vision and/or accommodative changes after refractive surgery in normal subjects were found. The reduction in fusional vergence is the most frequently reported alteration. Anisometropia is an important risk factor for postoperative binocular vision-related complaints. Most diplopia-related visual complaints, irrespective of the surgical procedure, were in fact misdiagnosed preoperative disorders. The preoperative evaluation of patients seeking spectacle/contact lens independence should include a complete binocular and accommodation assessment where parameters such as the phoric posture, accommodative amplitude and facility, near point of convergence, fusional reserves and accommodative convergence/accommodation coefficient are measured. This would allow the identification of risk factors that could compromise the success of the refractive surgery and cause clinical symptoms.
Collapse
Affiliation(s)
- María García‐Montero
- Optics II Department Faculty of Optics and Optometry Complutense University of Madrid Madrid Spain
| | - César Albarrán Diego
- Optics, Optometry and Visión Sciences Department Faculty of Physics University of Valencia Burjassot Spain
- Baviera Clinic Castellón de la Plana Spain
| | - Nuria Garzón‐Jiménez
- Optics II Department Faculty of Optics and Optometry Complutense University of Madrid Madrid Spain
- IOA Madrid Innova Ocular Madrid Spain
| | | | | | - Juan Carlos Ondategui‐Parra
- Centre of Development of systems, instrumentation and sensors (CD6) Universitat Politécnica de Catalunya Terrasa Spain
| |
Collapse
|
3
|
Kraus CL. September consultation #7. J Cataract Refract Surg 2018; 44:1162-1163. [PMID: 30165942 DOI: 10.1016/j.jcrs.2018.07.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
4
|
Refractive Errors & Refractive Surgery Preferred Practice Pattern®. Ophthalmology 2018; 125:P1-P104. [DOI: 10.1016/j.ophtha.2017.10.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 10/02/2017] [Indexed: 11/19/2022] Open
|
5
|
Impact of laser refractive surgery on ocular alignment in myopic patients. Eye (Lond) 2014; 28:1321-7. [PMID: 25190533 DOI: 10.1038/eye.2014.209] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 07/10/2014] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To evaluate the impact of myopic keratorefractive surgery on ocular alignment. METHODS This prospective study included 194 eyes of 97 myopic patients undergoing laser refractive surgery. All patients received a complete ophthalmic examination with particular attention to ocular alignment before and 3 months after surgery. RESULTS Patients with a mean age of 26.6 years and a mean refractive error of -4.83 diopters (D) myopia were treated. Asymptomatic ocular misalignment was present preoperatively in 46 (47%) patients: a small-angle heterophoria (1-8 prism diopters, PD) in 36%; and a large-angle heterophoria (>8 PD)/heterotropia in 11%. Postoperatively, the change in angles of 10 PD or greater occurred in 3% for distance and 6% for near fixation: in 7% of the patients with orthophoria, in 3% of those with a small-angle heterophoria, and in 18% of those with a large-angle heterophoria/heterotropia. No patient developed diplopia. The preoperative magnitude of myopia or postoperative refractive status was not related to the change in ocular alignment. The higher anisometropia was associated with a decrease in deviation (P=0.041 for distance and P=0.002 for near fixation), whereas the further near point of convergence tended to be related with an increase in near deviation (P=0.055). CONCLUSIONS Myopic refractive surgery may cause a change in ocular alignment, especially in cases with a large-angle heterophoria/heterotropia. There is also a chance of improvement of misalignment in patients with anisometropia.
Collapse
|
6
|
Han J, Hong S, Lee S, Kim JK, Lee HK, Han SH. Changes in fusional vergence amplitudes after laser refractive surgery for moderate myopia. J Cataract Refract Surg 2014; 40:1670-5. [PMID: 25149555 DOI: 10.1016/j.jcrs.2014.01.043] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Revised: 01/11/2014] [Accepted: 01/22/2014] [Indexed: 11/19/2022]
Abstract
PURPOSE To analyze the effect of bilateral laser refractive surgery on fusional vergence amplitude and near point convergence in normal orthotropic myopic patients. SETTING Cornea and refractive private practice, Seoul, South Korea. DESIGN Prospective observational study. METHODS Moderately myopic patients (2.0 to 6.0 diopters [D]) had bilateral laser refractive surgery with postoperative follow-ups at 1 week and 1 and 3 months. Patients with manifest strabismus, previous strabismus surgery, amblyopia, absent or impaired binocularity, or planned monovision were excluded. The preoperative and postoperative examinations included uncorrected and corrected visual acuities; a prism cover test; evaluation of the convergence, divergence, and vertical fusion amplitude using a rotary prism; and near point convergence. RESULTS The mean age of the 30 patients was 29 years ± 4 (SD). The mean preoperative refractive error was -4.10 ± 1.32 D in right eyes and -4.14 ± 1.37 D in left eyes. The convergence amplitude at near decreased 1 week and 1 month postoperatively, after which it progressively stabilized to near preoperative values. The convergence amplitude at far (break point) was not changed postoperatively; however, the convergence amplitude at far (recovery point) was increased at 1 month and 3 months (P=.008 and P=.003, respectively). There was a slight increase in near point convergence at 3 months (P<.001). CONCLUSIONS Although fusional vergence amplitudes at near and near point convergence changed after laser refractive surgery, the changes observed were small or transient. However, patients with latent phoria or strabismus should be warned before having refractive surgery. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
Collapse
Affiliation(s)
- Jinu Han
- From the Institute of Vision Research (J. Han, Hong, H.K. Lee, S-H Han), Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, SU Yonsei Eye Clinic (S. Lee), and B & VIIT Eye Center (Kim), Seoul, South Korea
| | - Samin Hong
- From the Institute of Vision Research (J. Han, Hong, H.K. Lee, S-H Han), Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, SU Yonsei Eye Clinic (S. Lee), and B & VIIT Eye Center (Kim), Seoul, South Korea
| | - Seungjae Lee
- From the Institute of Vision Research (J. Han, Hong, H.K. Lee, S-H Han), Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, SU Yonsei Eye Clinic (S. Lee), and B & VIIT Eye Center (Kim), Seoul, South Korea
| | - Jin Kook Kim
- From the Institute of Vision Research (J. Han, Hong, H.K. Lee, S-H Han), Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, SU Yonsei Eye Clinic (S. Lee), and B & VIIT Eye Center (Kim), Seoul, South Korea
| | - Hyung Keun Lee
- From the Institute of Vision Research (J. Han, Hong, H.K. Lee, S-H Han), Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, SU Yonsei Eye Clinic (S. Lee), and B & VIIT Eye Center (Kim), Seoul, South Korea
| | - Sueng-Han Han
- From the Institute of Vision Research (J. Han, Hong, H.K. Lee, S-H Han), Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, SU Yonsei Eye Clinic (S. Lee), and B & VIIT Eye Center (Kim), Seoul, South Korea.
| |
Collapse
|
7
|
Heinmiller LJ, Wasserman BN. Diplopia after laser in situ keratomileusis (LASIK) in a patient with a history of strabismus. J AAPOS 2013; 17:108-9. [PMID: 23340382 DOI: 10.1016/j.jaapos.2012.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Revised: 09/06/2012] [Accepted: 10/08/2012] [Indexed: 10/27/2022]
Abstract
In patients with a history of strabismus, refractive surgery can result in decompensation of ocular alignment, with subsequent diplopia. Refractive surgery in the management of strabismus has been described, although it remains controversial. We present a young adult with past history of strabismus surgery and new-onset diplopia after refractive surgery. Binocular diplopia was treated surgically with laser in situ keratomileusis.
Collapse
|
8
|
Abstract
PURPOSE OF REVIEW To evaluate recent literature regarding indications and outcomes for refractive surgery in children, including laser in-situ keratomileusis, laser epithelial keratomileusis, photorefractive keratectomy, and refractive intraocular lens placement. RECENT FINDINGS Refractive surgery in children is controversial. Recent publications have reported refractive surgery to treat strabismus and both ametropic and anisometropic amblyopia. Questions remain as to the age at which to perform the surgery, and which specific procedure to perform. Choice of technique depends on the clinical situation. SUMMARY Refractive surgery is an option for children with amblyopia and strabismus who fail treatment with spectacles or contact lenses. Prospective controlled studies are needed, and longer follow-up will answer questions about the utility and safety of refractive surgery in children.
Collapse
|
9
|
Guo S, Wagner R, Gewirtz M, Maxwell D, Pokorny K, Tutela A, Caputo A, Zarbin M. Diplopia and strabismus following ocular surgeries. Surv Ophthalmol 2010; 55:335-58. [PMID: 20452637 DOI: 10.1016/j.survophthal.2009.08.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2009] [Revised: 08/13/2009] [Accepted: 08/18/2009] [Indexed: 10/19/2022]
Abstract
Postoperative diplopia and strabismus may result from a variety of ocular surgical procedures. Common underlying mechanisms include sensory disturbance, scarring, direct extraocular muscle injury, myotoxicity from injections of local anesthesia or antibiotics, and malpositioning of extraocular muscles by implant materials. The most common patterns are vertical and horizontal motility disturbance. Treatment options include prisms, botulinum, occlusion, or surgery.
Collapse
Affiliation(s)
- Suqin Guo
- Institute of Ophthalmology and Visual Science, UMDNJ-New Jersey Medical School, Newark, New Jersey 07103, USA
| | | | | | | | | | | | | | | |
Collapse
|
10
|
Astle WF, Papp A, Huang PT, Ingram A. Refractive laser surgery in children with coexisting medical and ocular pathology. J Cataract Refract Surg 2006; 32:103-8. [PMID: 16516787 DOI: 10.1016/j.jcrs.2005.11.028] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2005] [Accepted: 02/17/2005] [Indexed: 11/25/2022]
Abstract
PURPOSE To report the visual, refractive, and functional outcomes of photorefractive keratectomy (PRK) and of laser-assisted subepithelial keratectomy in a group of children with significant refractive error and underlying medical conditions or ocular pathology who were noncompliant with traditional management. SETTING Nonhospital surgical facility and a hospital clinic. METHODS This case series comprised 5 individual cases of anisometropic amblyopia and/or high myopia. Underlying medical and ocular conditions were as follows: upper eyelid hemangioma with oblique myopic astigmatism, Pelizaeus-Merzbacher leukodystrophy with nystagmus, Klippel-Trenaunay-Weber syndrome with glaucoma, incontinentia pigmenti with unilateral optic nerve atrophy, and Goldenhar syndrome with unilateral optic nerve hypoplasia. Photorefractive keratectomy or LASEK was performed in 6 eyes of 5 patients. Age range at the time of surgery was 1.0 to 7.0 years. All procedures were performed under general anesthesia. RESULTS Best corrected visual acuity improved by 2 lines in 2 patients and 1 line in 2 patients by 6 months after surgery. Stereopsis and/or fusional status improved in 3 patients. Amblyopia treatment compliance improved in 1 patient. Alignment improved without strabismus surgery in 2 cases. A functional vision survey demonstrated a positive effect on the ability of all 5 children to function in their environment. CONCLUSION During the period of visual cortical plasticity, refractive surgery, by eliminating the refractive component of amblyopia and by promoting fusional ability, provides considerable improvement in children, even those with underlying medical conditions associated with ocular pathology.
Collapse
Affiliation(s)
- William F Astle
- Alberta Children's Hospital, University of Calgary, Division of Ophthalmology, Canada
| | | | | | | |
Collapse
|
11
|
Wasserman BN, Bigler B, Nipper K. Unexpected outcomes associated with laser in situ keratomileusis: ptosis, anisocoria, and "curing" of exotropia. J Cataract Refract Surg 2005; 31:1238-41. [PMID: 16039504 DOI: 10.1016/j.jcrs.2004.10.066] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2004] [Indexed: 11/24/2022]
Abstract
Laser in situ keratomileusis (LASIK) is a common and popular procedure that is generally associated with excellent results and few complications. We present 3 cases of unusual LASIK-related complications. In the first case, the patient developed anisocoria after otherwise unremarkable surgery. In the second case, the patient developed mild eyelid ptosis. In the third case, the patient's exotropia resolved after mild refractive overcorrection. In each case, the visual outcome was excellent and no further intervention was necessary.
Collapse
|