Refractive surgery and strabismus

Abstract

This review discusses the potential for strabismic complications after refractive surgery for hyperopia, myopia, anisomyopia, astigmatism and monovision, and how to avoid these complications. Guidelines are given for assessing patients with strabismus seeking refractive surgery. Screening tests are suggested that lead to stratification of refractive surgery patients into different risk groups each warranting a different intensity of evaluation.

Binocular decompensation and diplopia after refractive laser surgery

“…To minimize the risk of postoperative diplopia, risk groups and suggestions for additional tests should be defined. Several authors have described a minimum screening technique to evaluate the binocular functions before refractive surgery, and risk factors graded in low, moderate and high risk have been suggested (Godts et al, 2006;Kowal et al 2005;Kowal, 2000;Kushner & Kowal, 2003;Holland, Amm, & de Decker, 2000). We support these recommendations.…”

“…Refractive laser surgery is not known to change the AC/A, and a near add will still be needed. A similar case has been reported where the patient had convergence excess, but the refractive surgeon was not aware that the patient wore progressive lenses (Kowal et al, 2005). If this was the case for our patient, reading glasses may be indicated even after strabismus surgery to keep the esodeviation controlled.…”

Binocular decompensation and diplopia after refractive laser surgery

“…To minimize the risk of postoperative diplopia, risk groups and suggestions for additional tests should be defined. Several authors have described a minimum screening technique to evaluate the binocular functions before refractive surgery, and risk factors graded in low, moderate and high risk have been suggested (Godts et al, 2006;Kowal et al 2005;Kowal, 2000;Kushner & Kowal, 2003;Holland, Amm, & de Decker, 2000). We support these recommendations.…”

“…Refractive laser surgery is not known to change the AC/A, and a near add will still be needed. A similar case has been reported where the patient had convergence excess, but the refractive surgeon was not aware that the patient wore progressive lenses (Kowal et al, 2005). If this was the case for our patient, reading glasses may be indicated even after strabismus surgery to keep the esodeviation controlled.…”

Refractive Errors & Refractive Surgery Preferred Practice Pattern®

“…Apparent regression after refractive surgery can be due to a natural age-related hyperopic shift, or to the emergence of residual or incompletely treated hyperopia as latent hyperopia becomes manifest. 438 As with myopic LASIK, many of the more serious complications of H-LASIK are associated with the creation of the corneal flap. Most microkeratomes are capable of making the larger flaps needed for hyperopic corrections, but thin flaps may be more difficult to create and larger flaps can be associated with more bleeding if limbal vascularization is present.…”

Twenty Years after Childhood Strabismus Surgery

“……”

Binocular decompensation and diplopia after refractive laser surgery

“…To minimize the risk of postoperative diplopia, risk groups and suggestions for additional tests should be defined. Several authors have described a minimum screening technique to evaluate the binocular functions before refractive surgery, and risk factors graded in low, moderate and high risk have been suggested (Godts et al, 2006;Kowal et al 2005;Kowal, 2000;Kushner & Kowal, 2003;Holland, Amm, & de Decker, 2000). We support these recommendations.…”

“…Refractive laser surgery is not known to change the AC/A, and a near add will still be needed. A similar case has been reported where the patient had convergence excess, but the refractive surgeon was not aware that the patient wore progressive lenses (Kowal et al, 2005). If this was the case for our patient, reading glasses may be indicated even after strabismus surgery to keep the esodeviation controlled.…”

Refractive Errors & Refractive Surgery Preferred Practice Pattern®

“…Apparent regression after refractive surgery can be due to a natural age-related hyperopic shift, or to the emergence of residual or incompletely treated hyperopia as latent hyperopia becomes manifest. 438 As with myopic LASIK, many of the more serious complications of H-LASIK are associated with the creation of the corneal flap. Most microkeratomes are capable of making the larger flaps needed for hyperopic corrections, but thin flaps may be more difficult to create and larger flaps can be associated with more bleeding if limbal vascularization is present.…”

Twenty Years after Childhood Strabismus Surgery

“……”

Binocular decompensation and diplopia after refractive laser surgery

“…To minimize the risk of postoperative diplopia, risk groups and suggestions for additional tests should be defined. Several authors have described a minimum screening technique to evaluate the binocular functions before refractive surgery, and risk factors graded in low, moderate and high risk have been suggested (Godts et al, 2006;Kowal et al 2005;Kowal, 2000;Kushner & Kowal, 2003;Holland, Amm, & de Decker, 2000). We support these recommendations.…”

“…Refractive laser surgery is not known to change the AC/A, and a near add will still be needed. A similar case has been reported where the patient had convergence excess, but the refractive surgeon was not aware that the patient wore progressive lenses (Kowal et al, 2005). If this was the case for our patient, reading glasses may be indicated even after strabismus surgery to keep the esodeviation controlled.…”

Refractive Errors & Refractive Surgery Preferred Practice Pattern®

“…Apparent regression after refractive surgery can be due to a natural age-related hyperopic shift, or to the emergence of residual or incompletely treated hyperopia as latent hyperopia becomes manifest. 438 As with myopic LASIK, many of the more serious complications of H-LASIK are associated with the creation of the corneal flap. Most microkeratomes are capable of making the larger flaps needed for hyperopic corrections, but thin flaps may be more difficult to create and larger flaps can be associated with more bleeding if limbal vascularization is present.…”

Twenty Years after Childhood Strabismus Surgery

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