Artikel
Pediatric excimer laser refractive surgery – PRK and LASEK for high myopic anisometropia and amblyopia: Results of 11-year experiences
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Autoren
Veröffentlicht: | 18. September 2006 |
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Gliederung
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Objective
To evaluate the visual and refractive outcomes of multizonal photorefractive keratectomy (PRK) and laser subepithelial keratomileusis (LASEK) for high myopic anisometropia and contact lens intolerance in 58 children treated from January 1995 in the categories of obligatory and functional indications.
Methods
Group 1: Twenty six patients aged 7.1 to 15 years underwent multizonal PRK on the more myopic eye. Group 2: Thirty two patients aged 4 to 7 years (mean, 5.35 years) with high myopic anisometropia and amblyopia had performed multizonal PRK (13 eyes) or LASEK (19 eyes) on the more myopic eye in general anesthesia, Excimer laser Nidek EC 5000 was used. Refractive surgical data reported in standard format to describe safety, efficacy, predictability and stability of the procedure. A long-term binocular vision outcome was analyzed. All patients completed 2 to 11 years follow-up postoperatively. In children up to 8 years of age, surgery was followed by patching of the dominant eye.
Results
Group 1: The mean preoperative spherical equivalent (SE) refraction was -8.72±1.41 diopters (D) and the mean postop. SE -1.43 D (P<0.05). The mean preop UCVA 0.038 increased to 0.41 (P<0.05) postop. The mean preop. BSCVA was 0.54 and changed to 0.68 postop. The safety index was 1.24. All the eyes had no line lost in BSCVA, 12 eyes had one line gained and 9 eyes had two lines gained. Group 2: The mean preoperative spherical equivalent (SE) refraction in Group A was -8.45±2.71 diopters (D) decreased to -1.68 D at 2-3 years postop. The mean preop. BSCVA 0.21 improved to 0.76 by 2-3 years postop. None of the eyes had grade +3 of haze. Postoperative binocular vision was saved or improved.
Conclusions
PRK and LASEK, are effective and safe methods to reduce high myopic anisometropia in children aged 4 to 15 years and to improve amblyopia in children aged 4 to 7 years, when contact lens intolerance. Final visual acuity and binocular vision outcomes may be significantly better in children up to 7 years who receive a permanent surgical correction of anisometropia than patients treated by contact lenses.