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25歳女性が角膜屈折矯正手術を希望して受診した。幼少時から高度遠視と調節性内斜視があり,眼鏡を好まず,花粉症とドライアイでコンタクトレンズを常時使用でさなかった。初診時視力は,右0.8(1.2×+8.0D cyl−1.5DAx180°),左0.8(1.2×+8.25D cyl−1.0DAx180°)。裸眼での眼位は,右眼・左眼固視ともに16△ETL/R8△であった。レーザー角膜内切削形成術(LASIK)後の視力は,右0.9(1.0×1.25D cyl−0.5DAx145°),左1.0(1.2×+25D)となり,水平眼位は,右眼固視で0△,左眼固視で6△の内斜視になった。視力と眼位が改善し,眼精疲労が軽減し,患者は満足した。遠視矯正LASIKが屈折調節性内斜視に対して視力と眼位の矯正法として有用であった症例である。
A 25-year-old female presented with hyperopia and accommodative esotropia since childhood. Her uncorrected visual acuity was 0.8 in either eye. Cycloplegic refraction was +8.25D right and +8.5D left. The prism cover test showed a comitant esotropia by 16△ without glasses in both near and far vision. Laser in situ keratomileusis (LASIK) resulted in uncorrected visual acuity of 1.0 right and 1.21 eft. Six months after surgery, she had a residual esotropia by 6△. She was vary happy because she did not need eyeglasses any more and was relieved from asthenopia. This case illustrates that LASIK is effective for accommodative esotropia.
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