Facilitation of amblyopia management by laser in situ keratomileusis in children with myopic anisometropia.
OBJECTIVE
To evaluate the effects of Laser in situ keratomileusis (LASIK) in decreasing myopic anisometropia in children with spectacles or contact lens intolerance and its validity in facilitating treatment of resultant myopic anisometropic amblyopia.


METHODS
LASIK was performed for 18 eyes of 18 children having myopic anisometropic amblyopia not successfully treated with the standard amblyopia treatment for 6 months. Children were followed up at 1 week, 1, 2, 6, 12, 18, and 24 months. Postoperative amblyopia therapy was continued with occlusion of the dominant eye for 6 hr daily for the first 3 months and then for 4 hr per day as long as possible.


RESULTS
The mean spherical equivalent refraction in the operated eye had reduced significantly from -9.25 +/- 3.43D preoperatively to -1.5 +/- 1.23D at 2 years postoperatively. The mean spherical equivalent in the non operated fellow eye was -1.0 +/- 1.18D preoperatively and -2.25 +/- 1.05D at 2 years. The mean spherical equivalent myopic anisometropia was -7.75 +/- 2.34D preoperatively and -0.5 +/- 0.31D at 2 years, representing a 93.5% reduction in myopic anisometropia. At 6 months, 14 eyes (77.8%) were within +/-1D of the targeted refraction and at 2 years, 10 eyes (55.6%) were within +/-1.0D. The mean regression value was -2.25 +/- 1.7D, however, 15 eyes (83.3%) were within 3.0D of the fellow eye. The mean BCVA was significantly improved from 0.26 +/- 0.21 preoperatively to 0.82 +/- 0.17 by 2 years after LASIK with amblyopia treatment.


CONCLUSIONS
LASIK is a safe and effective alternative method for correcting myopic anisometropia facilitating treatment of amblyopia, only considerd in children with spectacles or contact lens intolerance, with more improved visual acuity and binocular vision.
Ghanem
Assad A
AA
Mansoura Ophthalmic Center, Mansoura University, Mansoura, Egypt. asaadghanem@hotmail.com
Nematallah
Ehab H
EH
El-Adawy
Ibrahim T
IT
Anwar
Ghada M
GM
D000550:Amblyopia / Q000503:physiopathology / Q000601:surgery*; D015858:Anisometropia / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D012029:Refraction, Ocular / Q000502:physiology; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology