Laser-assisted subepithelial keratectomy in children.
OBJECTIVE
To evaluate whether laser-assisted subepithelial keratectomy (LASEK) achieves effective targeted myopic correction with less post-treatment corneal haze than observed with photorefractive keratectomy (PRK) in children who fail traditional forms of treatment for myopic anisometropic amblyopia and high myopia.


METHODS
Nonhospital surgical facility with follow-up in a hospital clinic setting.


METHODS
This prospective study comprised 36 eyes of 25 patients. The mean patient age at treatment was 8.27 years (range 1.0 to 17.4 years). Patients were divided into 3 groups: those with myopic anisometropic amblyopia (13 patients/13 eyes), those with bilateral high myopia (11 patients/22 eyes), and those with high myopia post-penetrating keratoplasty (1 patient/1 eye). All patients were treated with LASEK under general anesthesia using the Visx 20/20 B excimer laser and a multizone, multipass ablation technique. Although the myopia was as high as -22.00 diopters (D) spherical equivalent (SE) in some eyes, no eye was treated for more than -19.00 D SE.


RESULTS
At 1 year, the mean SE decreased from -8.03 D to -1.19 D. Forty-four percent of eyes were within +/-1.0 D of the targeted correction; 78% of eyes had clear corneas with no haze. In the entire group, the mean best corrected visual acuity improved from 20/80 to 20/50. A functional-vision survey demonstrated a positive effect on the patients' ability to function in their environments after LASEK.


CONCLUSIONS
Laser-assisted subepithelial keratectomy in children represents another method of providing long-term resolution of bilateral high myopia and myopic anisometropic amblyopia with minimal post-laser haze. The reduction in post-laser haze with LASEK compared to that with the standard PRK technique may represent an advantage in treating these complex patients.
Astle
William F
WF
Alberta Children's Hospital, University of Calgary Division of Ophthalmology, Calgary, Alberta, Canada.
Huang
Peter T
PT
Ingram
April D
AD
Farran
R Peter
RP
D000293:Adolescent; D000550:Amblyopia / Q000503:physiopathology / Q000601:surgery; D000768:Anesthesia, General / Q000379:methods; D015858:Anisometropia / Q000503:physiopathology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003315:Cornea / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D049008:Keratectomy, Subepithelial, Laser-Assisted / Q000379:methods*; D008297:Male; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology