Artificial divergence surgery and myopic shift

Introduction Congenital Nystagmus are often dampened at near fixation by convergence. Artificial Divergence Surgery (ADS) aims to elicit convergence at far fixation and permanently block nystagmus. A possible myopic shift due to accommodative convergence following ADS was studied. Methods 139 cases of ADS were reviewed. Visual acuity and refraction measured by the power of the glasses were studied (follow up 5 years). Results were discussed according to age and ocular alignment (orthotropia 70 %, exophoria 30 %) Results and Discussion Refraction changed to higher myopia, approximately -1,5 dioptres within 5 years. Care is mandatory for analysis since children have a physiological myopic shift. Moreover, some glasses were purposely overcorrected to relieve exophoria. Conclusion The myopic spasm is rare after ADS, and very mild if present.