Visual And Safety Outcomes Of Refractive Lens Exchange With Multifocal Intraocular Lens For The Treatment Of Refractive Accommodative Esotropia

To demonstrate the effectiveness of refractive lens exchange (RLE) with multifocal intraocular lens (MFIOL) to correct fully accommodative esotropia in patients who desire to be spectacles independent and who are not suitable for other refractive procedures (PRK, LASIK, ICL, etc.)

Private tertiary ophthamlomory clinic/surgery center

This is a retrospective case series study. 3 patients were included and who have diagnosis of fully accommodative exotropia and wish to be spectacle free. These patients were not suitable for common refractive surgery for different reasons. 6 eyes underwent RLE with MFIOL. Data were collected preoperatively at 1-, 2-, 3- and 9-month follow-up visits after each treatment.

The mean age of the patients at time of RLE was 22.1.  Mean spherical equivalent decreased from +3.8 ± 1.211 diopters (D) (hyperopia) before surgery to +0.35 ± 0.52 D after surgery (P<0.001). The mean angle of deviation without correction was 22.0 prism diopters (Δ) before surgery and 3.25 Δ after surgery (P<0.001). There were no significant differences observed between the preoperative and postoperative mean best-corrected visual acuity (p=0.32). There were no complications.

Refractive surgery may be performed successfully and safely in patients with accommodative esotropia who are not suitable for other refractive procedures. More studies are needed to increase the patient experience and extend the follow-up period in order to evaluate the stability of these results over time.