title: Pediatric PRK (PhotoRefractive Keratectomy) with Mitomycin C (MCC) for Persistent Anisometropic Amblyopia. A Case Report.
abstract: OBJECTIVE
  To evaluate the safety and efficacy of photorefractive keratectomy (PRK) with Mitomycin C (MMC) for the treatment of severe pediatric anisometropia and amblyopia resistant to more conservative treatment modalities.
  
  
  METHODS
  A 3 year-old-child, who at 18 months old underwent unilateral diode laser treatment for threshold ROP, developed 11 diopters of anisometropic myopia and secondary dense amblyopia of the Right Eye. Only after all conservative treatment options failed was he treated with PRK and MMC.  Principal outcome measures included cycloplegic refraction, the amount of refractive correction, degree of corneal haze and change in visual acuity.
  
  
  RESULTS
  On presentation: BCVA: 20/CF OD; 20/30 OS.  CRNS:  -11.50 diopters sphere OD; -0.50 diopters sphere OS. Unilateral PRK followed by application of MMC (0.2 mg/ml) for 1 min was performed under general anesthesia.  Three-month postoperative findings include: VA: 20/30 OD; 20/25 OS.  CRNS: +0.25 diopters sphere OD.  At one year, the BCVA remained equal at the 20/30 level despite mild myopic regression OD. CRNS OD at one year was -1.25 +050 x 116. No corneal haze was appreciated.
  
  
  CONCLUSIONS
  In this child, treatment with PRK and MMC safely reduced the anisometropia thus facilitating his visual rehabilitation.  While encouraging, further study is required to verify the longer term results of this single case.
  
  
  OBJECTIVE
  To evaluate the safety and efficacy of photorefractive keratectomy (PRK) with Mitomycin C (MMC) for the treatment of severe pediatric anisometropia and amblyopia resistant to more conservative treatment modalities.
  
  
  METHODS
  A 3 year-old-child, who at 18 months old underwent unilateral diode laser treatment for threshold ROP, developed 11 diopters of anisometropic myopia and secondary dense amblyopia of the Right Eye. Only after all conservative treatment options failed was he treated with PRK and MMC.  Principal outcome measures included cycloplegic refraction, the amount of refractive correction, degree of corneal haze and change in visual acuity.
  
  
  RESULTS
  On presentation: BCVA: 20/CF OD; 20/30 OS.  CRNS:  -11.50 diopters sphere OD; -0.50 diopters sphere OS. Unilateral PRK followed by application of MMC (0.2 mg/ml) for 1 min was performed under general anesthesia.  Three-month postoperative findings include: VA: 20/30 OD; 20/25 OS.  CRNS: +0.25 diopters sphere OD.  At one year, the BCVA remained equal at the 20/30 level despite mild myopic regression OD. CRNS OD at one year was -1.25 +050 x 116. No corneal haze was appreciated.
  
  
  CONCLUSIONS
  In this child, treatment with PRK and MMC safely reduced the anisometropia thus facilitating his visual rehabilitation.  While encouraging, further study is required to verify the longer term results of this single case.
authors.forename: Courtney M
authors.initials: CM
authors.lastname: Crawford
authors.forename: Travis C
authors.initials: TC
authors.lastname: Frazier
authors.forename: Mark F
authors.initials: MF
authors.lastname: Torres
authors.forename: Robert W
authors.initials: RW
authors.lastname: Arnold
authors.forename: Robert A
authors.initials: RA
authors.lastname: Mazzoli
authors.forename: William R
authors.initials: WR
authors.lastname: Raymond
mesh_terms: D000550:Amblyopia; D002648:Child; D006801:Humans; D054018:Lasers, Excimer; D016685:Mitomycin / Q000008:administration & dosage; D009216:Myopia; D018903:Photorefractive Keratectomy; D011446:Prospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity
chemical_list: D016685:Mitomycin