Surgical versus optical treatment for anisometropia in adults: a randomized controlled trial

Abstract

Background: We evaluated and compared outcomes of laser-assisted in situ keratomileusis (LASIK) versus optical spectacle correction for the treatment of anisometropia in adult patients.
 Methods: This prospective, randomized controlled clinical trial included 50 eyes of 50 patients. We randomly allocated participants to Group A (25 eyes with anisometropia assigned to LASIK treatment) and Group B (25 eyes with anisometropia assigned to optical spectacle correction). All patients underwent preoperative and postoperative visual acuity, subjective and cycloplegic refraction, fundus, slit-lamp, and corneal topography examinations.
 Results: In Group A, at 1-month postoperatively, there were statistically significant differences in uncorrected distance visual acuity, corrected distance visual acuity, refractive sphere, cylinder, and spherical equivalent (SE) as compared to baseline. At 3-months postoperatively in Group A, SE showed good stability within ± 0.50 diopter (D) in 22 eyes (88%) and within ± 0.75 D in 23 eyes (92%), while two eyes had an SE beyond 1.00 D emmetropia. Five eyes had amblyopia with minimal improvement in two eyes in Group A after LASIK, and no improvement in three eyes treated with spectacles in Group B. Two amblyopic eyes had developed ocular deviations by the end of the study that referred to the strabismus unit.
 Conclusions: Our outcomes revealed that LASIK was more effective and advantageous than spectacles in the treatment of different types of anisometropia in adults. However, future randomized trials should focus on optical versus surgical treatment of anisometropia and anisometropic amblyopia in both pediatric and adult patients, to verify these conclusions before generalizing this treatment modality.