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Excimer laser correction for myopic anisometropic amblyopia in pediatric patients‐ Long term results
Author(s) -
Autrata R.,
Krejcirova I.,
Griscikova L.
Publication year - 2016
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2016.0553
Subject(s) - anisometropia , medicine , visual acuity , keratometer , refractive error , ophthalmology , stereoscopic acuity , surgery , optometry
Purpose To evaluate the efficacy, predictabilty, safety, stability, visual acuity and binocular vision results of laser‐assisted subepithelial keratectomy (LASEK) for the correction of high myopic anisometropia and amblyopia in children. Methods Our study comprised 195 eyes of 195 pediatric patients that had LASEK for high myopic anisometropia from −5.5 to −11.5 D operated between 1998 and 2012. All children were unable to use spectacles due to aniseikonia, and they were noncompliant with contact lenses. They were at 3–8 years of age in time of surgery, Children younger than 7 years were operated in general anesthesia. All patients were treated with LASEK multizonal ablation technique. In all children surgery was followed by a half‐day patching of the dominant eye. Main outcome measures were cycloplegic refraction, uncorrected and best spectacle‐corrected visual acuity (UCVA, BSCVA resp.), keratometry, biometry, ocular alignment, corneal clarity and grade of stereopsis over 2–12 years of follow‐up. Results The preoperative mean spherical equivalent (MSE) was −8.32 D. The postoperative MSE was −1.21D at the last visit. The mean preop UCVA 0.033 increased to 0.59 (p < 0.05) postop. The mean preop. BSCVA was 0.38 and changed to 0.89 postop. The safety index was 1.79. All the eyes had no line lost in BSCVA, 60 eyes had two lines gained, 56 and 79 eyes had 3 and 4 or more lines gained, resp. Preoperative spectacle aniseikonia decreased from 11.6 to 2.1% postop. Binocular vision was improved and saved in 86% of children. No postoperative complications were observed. Conclusions Pediatric LASEK was highly effective and safe methods to reduce myopic anisometropia up to −12D, decrease spectacle aniseikoina, improve visual acuity and stereopsis in children aged 3–8 years with amblyopia when contact lens intolerance.