Laser in situ keratomileusis for treated myopic anisometropic amblyopia in children

Purpose: To evaluate the effects of laser in situ keratomileusis (LASIK) in decreasing myopic anisometropia in children with spectacles or contact lens intolerance and its validity in facilitating treatment of resultant myopic anisometropic amblyopia. Patients and methods: LASIK was performed in 18 eyes of 18 children having myopic anisometropic amblyopia not successfully treated with the standard amblyopia treatment for 6 months. Children were followed up at 1 week, 1, 2, 6, 12, 18 and 24 months. Postoperative amblyopia therapy was continued with occlusion of the dominant eye for 6 h daily for the first 3 months and then for 4 h per day as long as possible. Results: The mean spherical equivalent refraction in the operated eye had reduced significantly from -9.08 +/- 1.86D preoperatively to -0.97 +/- 1.16D at 2 years postoperatively. The mean spherical equivalent in the non-operated fellow eye was -1.0 +/- 1.15D preoperatively and -2.50 +/- 1.15D at 2 years. The mean spherical equivalent myopic anisometropia was -7.75 +/- 2.25D preoperatively and -0.50 +/- 0.31D at 2 years, representing a 93.5% reduction in myopic anisometropia. The mean regression value was -2.28 +/- 1.62D, however, 18 eyes (72%) were within 3.0D of the fellow eye. The mean BCVA was significantly improved from 0.72 +/- 0.13 preoperatively to 0.47 +/- 0.17 by 2 years after LASIK with amblyopia treatment. Conclusion: LASIK is a safe and effective alternative method for correcting myopic anisometropic amblyopia, especially in children with spectacles or contact lens intolerance, with more better visual acuity and binocular vision. (C) 2009 King Saud University. All rights reserved.