Long-term efficacy of excimer laser in situ keratomileusis in the management of children with high anisometropic amblyopia.
BACKGROUND
Children with anisometropic amblyopia are often noncompliant with traditional treatment including spectacules and contact lenses. This study was to evaluate the long-term efficacy of excimer laser in situ keratomileusis (LASIK) for children with high anisometropic amblyopia.


METHODS
A retrospective analysis of 24 children with high unilateral anisometropic amblyopia, who underwent LASIK during the period between August 2000 and September 2005 in our hospital, was conducted. The mean age of these children was (7.4 +/- 1.9) years (range 5 - 14 years) and the mean follow-up period was (33.3 +/- 14.2) months (range 18.5 - 74.2 months). After LASIK, visual acuity, refraction and far or near stereoacuity were analyzed. Near stereoacuity was measured by the random-dot butterfly stereogram and the pre-school random-dot stereogram, while far stereoacuity was measured by the synoptophore with Yan's random-dot stereogram.


RESULTS
Mean preoperative uncorrected visual acuity was 0.06 +/- 0.05, while mean postoperative uncorrected visual acuity was elevated to 0.43 +/- 0.33. Mean preoperative best-corrected visual acuity was 0.26 +/- 0.22, while mean postoperative best-corrected visual acuity was elevated to 0.67 +/- 0.40. For patients with myopic anisometropia, preoperative mean spherical equivalent refraction was (-8.01 +/- 2.70) D while postoperative value significantly reduced to (-1.32 +/- 2.47) D. For patients with hyperopic anisometropia, preoperative mean spherical equivalent refraction was (+7.35 +/- 1.55) D while postoperative value significantly reduced to (+3.30 +/- 0.86) D. These results demonstrated that there was statistical difference in these parameters between preoperative and postoperative tests. At the last follow-up, 20 patients had near stereoacuity, and the mean near stereoacuities measured by the random-dot butterfly stereogram and the preschool random-dot stereogram were (149.00 +/- 152.93)'' and (201.05 +/- 235.94)'', respectively. In contrast, 11 patients had far stereoacuity, and the mean far stereoacuity measured by the synoptophore was (210.91 +/- 217.51)''. Three cases of patients developed mild corneal complications.


CONCLUSIONS
LASIK for the correction of high anisometropia in children with monocular amblyopia may be safe and effective, and this can help effectively conduct postoperative amblyopia training and improve the cure rate.
Lin
Xiao-Ming
XM
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, China. linxiaom@mail.sysu.edu.cn
Yan
Xiao-He
XH
Wang
Zheng
Z
Yang
Bin
B
Chen
Qi-Wen
QW
Su
Jin-Ai
JA
Ye
Xue-Lian
XL
D000293:Adolescent; D000550:Amblyopia / Q000601:surgery*; D015858:Anisometropia / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity