Consecutive Exotropia after LASIK in a Patient with Accommodative Esotropia

PURPOSE: To report consecutive exotropia after hyperopic laser in situ keratomileusis (LASIK) in a patient with accommodative esotropia. METHODS: A 22-year-old female patient with hyperopia and mild to moderate amblyopia in her right eye was referred for accommodative esotropia. She had undergone right medial rectus recession 4 years ago. Examination revealed right esotropia of 25 and 6 prism diopters (PD) without and with correction, respectively. She underwent LASIK in both eyes to correct the refractive accommodative esotropia. Eight months after LASIK, her refraction was plano-0.75@160 and +0.5-0.75@180 in the right and left eyes respectively, but she developed right exotropia of 20 PD without correction. CONCLUSIONS: Although hyperopic LASIK may be considered as an alternative treatment for refractive accommodative esotropia, the presence of amblyopia and absence of fusion preoperatively increase the risk of postoperative exotropia.