Change in the accommodative convergence per unit of accommodation ratio after bilateral laser in situ keratomileusis for myopia in orthotropic patients

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.

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“…Postsurgery accommodative problems have been reported also with other techniques such as LASIK (Prakash et al. ,b; Liu et al. ; Han et al.…”

Section: Resultsmentioning

confidence: 94%

“…This sudden variation can trigger a change in accommodative amplitude, an ill‐sustained accommodation, or even an accommodative excess (Ciuffreda , Prakash et al. ,b).…”

Section: Resultsmentioning

confidence: 99%

Binocular vision alterations after refractive and cataract surgery: a review

García-Montero

Diego

Garzón

et al. 2018

Acta Ophthalmologica

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“…After LASIK, no significant change of AC/A ratio between the group wearing glasses before surgery and naked after surgery have been reported [8]. Prakash et al [4] reported a change in the stimulus AC/A ratio after bilateral LASIK following stabilization a few months after surgery. In the present study, we found an initial increase in the AC/A ratio early in the postoperative period.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, in the absence of the prismatic effect of concave glasses, the convergence required for near fusion is also altered in myopia [4]. Due to these conditions, patients with the Artisan PIOL implantation might experience asthenopic symptoms such as double vision and blurring immediately after surgery.…”

mentioning

confidence: 99%

Changes in the Accommodation-convergence Relationship after the Artisan Phakic Intraocular Lens Implantation for Myopic Patients

Ryu

Han

Kim

2014

Korean J Ophthalmol

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PurposeTo evaluate the change of accommodation-convergence parameters after implantation of Artisan phakic intraocular lens (PIOL).MethodsProspective study for the patients with the Artisan PIOL implantation was performed. A total of 37 patients (3 males and 34 females) enrolled the study. Preoperatively, convergence amplitude, the stimulus accommodative convergence per unit of accommodation (AC/A) ratio and the near point of convergence (NPC) were evaluated. After the Artisan PIOL implantation, the identical evaluations were repeated at 1 week, 1, 3, and 6 months after the surgery.ResultsMean age was 24.3 ± 4.8 years old, and preoperative refractive error was -8.92 ± 4.13 diopters (D). After the implantation, mean refractive errors significantly decreased to within ±1.00 D, and noticeable complications were not found. The convergence amplitude and the stimulus AC/A ratio increased 1 month after the surgery, but progressively stabilized afterward to near preoperative values. NPC didn't show any significant change over follow-up period up to 6 months.ConclusionsThese results regarding implantation of the Artisan PIOL revealed the increase of accommodation-convergence relationship within first 1 month after the surgery, but progressive stabilization was noted during follow-up periods.

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“…The stimulus AC/A ratio has been shown to reduce after LASIK at one-week and one-month follow ups, but returned to comparative baseline values at both three and nine month follow ups. (Prakash et al 2007) Cases of exophoric shifts after myopic LASIK have been reported, (Snir et al 2003) and an increase in accommodative amplitude in pre-presbyopic adults has been demonstrated after photorefractive keratectomy (PRK). (Karimian et al 2010) …”

Section: Binocular Vision In Orthokeratologymentioning

confidence: 99%

Binocular Visual Function in Orthokeratology Contact Lens Wear for Myopia

Gifford¹

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Change in the accommodative convergence per unit of accommodation ratio after bilateral laser in situ keratomileusis for myopia in orthotropic patients

Abstract: The AC/A ratio varied after LASIK, stabilizing between 3 months and 9 months after surgery. This suggests that the maximum variation in the accommodation-convergence relationship after LASIK occurs in the first 3 months.

Cited by 18 publications

References 6 publications

Binocular vision alterations after refractive and cataract surgery: a review

Binocular vision alterations after refractive and cataract surgery: a review

Changes in the Accommodation-convergence Relationship after the Artisan Phakic Intraocular Lens Implantation for Myopic Patients

Binocular Visual Function in Orthokeratology Contact Lens Wear for Myopia

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