Facilitation of amblyopia management by laser in situ keratomileusis in high anisometropic hyperopic and myopic children

Abstract

To assess the efficacy of laser in situ keratomileusis (LASIK) in facilitating amblyopia management of children from 6 to 14 years old, with high hyperopic and myopic anisometropia. Between 2000 and 2005, 42 children with high hyperopic anisometropic amblyopia and 32 children with high myopic anisometropic amblyopia underwent LASIK to reduce their anisometropia. LASIK was performed under topical or general anesthesia. Pre- and postoperative best-corrected visual acuity, cycloplegic refraction, and binocular vision were recorded. Follow-up ranged from 6 months to 3 years, the averages of which were 17.45 months in the hyperopic group and 18.31 months in myopic group. Hyperopic anisometropia correction ranged from +3.50 D to +7.75 D, and the mean postoperative anisometropia was +0.56 +/- 0.75 D at 3 years. Myopic anisometropia correction ranged from -15.75 to -5.00 D and the mean postoperative anisometropia at 3 years was -2.20 +/- 1.05 D. The best-corrected visual acuity for distance and reading in the myopic group improved from 0.4 +/- 0.25 and 0.58 +/- 0.27, respectively, before surgery to 0.59 +/- 0.28 and 0.96 +/- 0.35, respectively, 3 years after surgery. In the hyperopic group, best-corrected visual acuity for distance and reading improved from 0.23 +/- 0.21 and 0.34 +/- 0.32, respectively, before surgery to 0.53 +/- 0.31 and 0.80 +/- 0.33, respectively, 3 years after surgery. The proportion of patients who had stereopsis increased from 19.1% preoperatively to 46.7% postoperatively in the hyperopic group and from 19% to 89% in the myopic group. LASIK reduced high hyperopic and myopic anisometropia in children, thus facilitating amblyopia management and improving their visual acuity and stereopsis.