Citation:Zhang J,Yu KM.Femtosecond laser corneal refractive surgery for the correction of high myopic anisometropic amblyopia in juveniles.Int J Ophthalmol 2017;10(11):1678-1685,doi:10.18240/ijo.2017.11.07
Femtosecond laser corneal refractive surgery for the correction of high myopic anisometropic amblyopia in juveniles
Received:June 23, 2016  Revised:August 01, 2017
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DOI:10.18240/ijo.2017.11.07
Key Words:refractive surgery; myopic anisometropic; amblyopia; pediatric patients; small-incision lenticule extraction; femtosecond laser-assisted in situ keratomileusis
Fund Project:Supported by the National Natural Science Foundation (No.81470626).
     
AuthorInstitution
Jing Zhang State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou , Guangdong Province, China
Ke-Ming Yu State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou , Guangdong Province, China
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Abstract:
      AIM: To evaluate the effects of femtosecond laser-assisted in situ keratomileusis (FS-LASIK) and small-incision lenticule extraction (SMILE) to correct high myopic anisometropic amblyopia in juvenile patients.

    METHODS: From November 2013 to January 2015, 33 amblyopic patients with high myopic anisometropic amblyopia were studied. FS-LASIK (30 eyes) or SMILE (3 eyes) was performed in the amblyopic eyes. Visual acuity, refraction, contrast sensitivity, stereoacuity and complications were evaluated. Patients completed follow-up examinations at 3d, 1mo, 3mo and the last follow-up time (mean 8.17±3.23mo) after surgery.

    RESULTS: The mean age at surgery was 9.04±3.04y (range 6-16y). The mean spherical equivalent in the amblyopic eyes was significantly decreased from -10.00±2.39 D preoperatively to -0.06±1.06 D at 1mo, -0.19±1.33 D at 3mo and -0.60±1.43 D at approximately 8mo postoperatively (P<0.05 for all). The mean myopic anisometropia was significantly decreased from -9.45±2.33 D preoperatively to +0.37±1.48 D at 1mo, -0.46±1.47 D at 3mo and -0.09±1.83 D at approximately 8mo (P<0.05 for all). The logarithm of the minimum angle of resolution (logMAR) for uncorrected and corrected distance visual acuity (UDVA and CDVA, respectively) of the amblyopic eye improved from 1.74±0.35 and 0.98±0.63 preoperatively to 0.45±0.31 and 0.41±0.33 at approximately 8mo after surgery, respectively. The logMAR CDVA at 3d, 1, 3 and 8mo postoperatively improved by means of 1.42, 2.22, 2.96, and 4.39 lines, and a gain of more than two lines accounted for 45%, 50%, 74% and 86% of all patients, respectively. The contrast sensitivity of both amblyopic eyes and dominant eyes at 0.5, 2, 8 cycles per degree was significantly improved postoperatively (P<0.05 for all). Of the 33 pediatric patients, no patients had near stereopsis preoperatively and seven patients (21.2%) recovered near stereopsis (400″ to 60″) at approximately 8mo after surgery. No intraoperative or postoperative complications occurred in any patient.

    CONCLUSION: FS-LASIK or SMILE can be promising alternative methods to correct high myopic anisometropic amblyopia in juvenile patients who have failed with traditional approaches.

PMC FullText Html:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5686365/
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