Correction of accommodative esotropia using hyperopic implantable collamer lenses

Introduction: To report a case of accommodative esotropia and high hyperopia managed with the Visian implantable collamer lens (ICL) phakic intraocular lens. Patient and Clinical Findings: The patient is a 21-year-old man with cycloplegic refraction of +7.50 −2.00 × 180 in both eyes. In addition, he presented a 30 prism diopters (PD) esotropia for both distance and near, which improved to 5 PD wearing his full cycloplegic prescription. Diagnosis, Intervention, and Outcomes: A patient with high hyperopia and accommodative esotropia with unchanged ocular alignment along with stable cycloplegic refraction for 2 years underwent bilateral ICL implantation. No intraoperative or postoperative complications were observed during the 12-month follow-up. The manifest refraction improved to +0.75 −0.75 × 180 postoperatively in the right eye and to +0.25 −0.50 × 180 in the left eye. No eyes lost lines of visual acuity. The esotropia improved to 5 PD at both distance and near without the need for spectacles. Conclusions: Hyperopic ICL implantation for accommodative esotropia may be considered a viable option to achieve spectacle independence and maintain proper eye alignment.