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Outcomes of a combined management of refractive error and concomitant strabismus: no glasses, no squint

Poster Details

First Author: V.Flemrova CZECH REPUBLIC

Co Author(s):    A. Holubova   L. Filipova   S. Zapletalova              

Abstract Details


To evaluate the long-term stability of outcomes after a combination of refractive and strabismus surgeries in patients diagnosed with ametropia and concomitant strabismus, who want to be spectacle-independent and without squint.


European Eye Clinic Lexum, Prague, Czech Republic


This study comprised 17 patients with refractive error and strabismus who underwent a surgical correction of refractive error (laser surgery, phakic lens implantation or refractive lens exchange) and a strabismus surgery with adjustable sutures. Follow-up visits of the patients were scheduled at one week, two months, one year and then regularly once a year. We evaluated postoperative refraction and the stability of strabismus.


Out of the total number of 17 patients, 8 patients had exotropia (1 primary, 7 consecutive) and 9 patients had primary esotropia. A laser surgery (LASIK or femtosecond LASIK) was performed on 13 patients (21 eyes), the implantation of posterior chamber phakic lens (ICL) on 1 patient (1 eye), and a refractive lens exchange (RLE) on 3 patients (6 eyes). The spherical equivalent in eyes after the refractive surgery improved from a preoperative 1.96±4.20 D (-10.00 to 7.75 D) to a postoperative -0.09±0.36 D (-1.38 to 0.88 D). The preoperative angle of strabismus varied between -30 pdpt and +35 pdpt, the postoperative angle was within 0 ± 10 pdpt.


The spectrum of refractive errors in patients with strabismus is highly diverse. However, our study showed that a combined management of refractive error (laser surgery, phakic lens implantation or refractive lens exchange) and strabismus may be a good option for these patients. The combination of these surgeries led to a substantial improvement of the stability of the postoperative eye position, to an optimal correction of refractive error, and fulfilled the wish of the patients: no glasses, no squint.

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