Results Of Using Refractive Laser Correction Of Hyperopia In Children With Concomitant Convergent Strabismus Aznauryan I.E., Balasanyan V.O., Mordyukov E.I., Idrisova A.A., Rychkova S.I. Pediatric Eye Clinics "Yasnyi Vzor" Moscow, Russia

To evaluate long-term outcomes of excimer laser correction for hyperopia in children with concomitant convergent strabismus.

Pediatric Eye Clinics “Yasnyi Vzor”, Moscow, Russia.

Methods

Twenty-seven children aged 4–10 years (mean 6.3±1.3) with bilateral hyperopia and concomitant convergent strabismus were included. High hyperopia was present in 21 eyes and moderate in 33 eyes. Pre- and postoperative evaluation (1–5 years, mean 36.0±17.3 months) included autorefractometry, keratometry, pachymetry, A-scan biometry, anterior segment OCT, and assessment of deviation angle using videooculography and synoptophore. All patients underwent photorefractive keratectomy (MEL 90, Carl Zeiss). Outcomes assessed were spherical equivalent, corrected visual acuity (LogMAR), deviation angle, axial length, and corneal transparency.

Results

Spherical equivalent decreased from 5.6 [4.6–7.0] to 2.75 [1.5–3.4] D (p<0.001). Corrected visual acuity improved from 0.05 [0–0.15] to 0 [0–0.1] LogMAR (p=0.003). In children with partial accommodative strabismus, deviation angle decreased from 15° [10–18] to 3° [0–6] (p<0.001). Axial length showed minimal change (20.9 to 21.1 mm; p=0.05). Corneal opacities were observed in 11 children (22 eyes), predominantly mild (grade 0.5–1); moderate haze (grade 2) was noted in six eyes.

Excimer laser correction of hyperopia in carefully selected pediatric patients with concomitant convergent strabismus provides stable long-term refractive improvement, enhances corrected visual acuity, and significantly reduces deviation angle. Structural ocular parameters remain largely unchanged, and postoperative corneal haze is generally mild. The procedure may represent a viable adjunct in managing selected cases of hyperopia-associated strabismus.