title: Successful implementation of a protocol for photorefractive keratectomy in children requiring anesthesia.
abstract: OBJECTIVE
  To describe a protocol for treating children with photorefractive keratectomy (PRK) under general anesthesia and to review intraoperative and postoperative complications.
  
  
  METHODS
  Institutional academic practice.
  
  
  METHODS
  Nine patients between 3 years and 9 years of age were treated with PRK under general anesthesia for anisometropia with unilateral high myopia or high hyperopia and amblyopia of the affected eye. Induction of anesthesia and the surgical procedure were carried out in separate rooms. The laser beam was centered on the entrance pupil, and eye position was monitored throughout the procedure. Specific precautions were taken before and during the procedure to prevent unwanted effects of inhalational anesthetic agents on laser performance.
  
  
  RESULTS
  All children did well, with no anesthesia-related or treatment-related complications.
  
  
  CONCLUSIONS
  Our protocol for PRK under general anesthesia was effective and efficient in children who were unable to cooperate for the procedure using local anesthesia. It can be adapted for laser in situ keratomileusis and other refractive surgical procedures in children and uncooperative adults.
authors.affiliation: Cullen Eye Institute, Department of Ophthalmology, Texas Children's Hospital, Houston, Texas 77030, USA. epaysse@bcm.tmc.edu
authors.forename: Evelyn A
authors.initials: EA
authors.lastname: Paysse
authors.forename: Mohamed A W
authors.initials: MA
authors.lastname: Hussein
authors.forename: Douglas D
authors.initials: DD
authors.lastname: Koch
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Brady McCreery
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Glass
authors.forename: M Bowes
authors.initials: MB
authors.lastname: Hamill
mesh_terms: D000550:Amblyopia / Q000601:surgery*; D000768:Anesthesia, General; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D054018:Lasers, Excimer; D008297:Male; D018903:Photorefractive Keratectomy / Q000379:methods; D016896:Treatment Outcome