LASIK surgery for high myopic anisometropia in children

1. Quynh Le Thuy
2. Ton Thi Kim Thanh

Vietnam National Institute of Ophthalmology (VNIO), HaNoi, VietNam

Purpose: To evaluate the visual, refactive results, efficacy and safety of refractive surgery by laser in situ keratomileusis (LASIK) for treatment of pediatric anisometropia.

Setting: refractive surgery Department of Vietnam National Institute of Ophthalmology (VNIO).

Methods: Pediatric patients with anisometropic amblyopia who were unable or unwilling to use glasses or contact lens , and occlusion therapy to treat the amblyopia; The eye with the higher refractive error was treated with LASIK. Patients were under topical or general anesthesia. LASIK was performed using the Nidek EC 5000- CX III Laser Excimer and the Nidek MK-2000 Keratome system, which created a 130 μm corneal flap.

Cycloplegic refraction, uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA) were measured and compared preoperative and postoperative at the 1st, 3rd,6th,12th and 18th month.

Results: 58 eyes of 58 patients from 4 to 16 years old received refractive surgery by LASIK. Average of age at the time of surgery was 11.88±3.65 (SD). The mean preoperative spherical equivalent (SE) was –10.49±2.81D (range -4.25 to -16.25D) and the mean postoperative SE at 18 months was –1.21±1.25D. Compare BCVA pre-op and UCVA at 18th month post-op (57 patients):

* No patients lost one line or more of vision
* 6/57 patients (10.53%) regained their BCVA pre-op
* 26/57 patients (45.61%) gained 1 to 2 lines
* 25/57 patients( 43.86 %) improved 3 to 8 lines (Specially, 1 patient had 20/100

BCVA pre-op but post-operation UCVA gained 20/20 after 1, 3, 6, 12 and 18 months).
No complication was observed.

Conclusions: LASIK can be performed safely, effectively to improve the visual and resolve the anisometropia in children,when conventional therapies had failed. But we need much more time to follow the stable of refraction and complication may be occur in children.