LASIK Can Manage Pediatric Myopic Anisometropic Amblyopia, 10 Year Study Shows

Laser assisted in situ keratomileusis (LASIK) is safe and effective for correcting refractory pediatric myopic anisometropia, according to research published in Clinical Ophthalmology.

Researchers conducted a retrospective study to evaluate long-term safety, effectiveness, and stability of unilateral LASIK in pediatric myopic anisometropic amblyopia.

The study included children who received unilateral LASIK for myopic anisometropia of >6 diopter (D) after mandatory 6-month occlusion or penalization therapy at a single institute between January 2004 and July 2008. Patients had follow-up visits at 6 months, 1 year, and 2 years and then biannually until 10 years. The study outcome measures included visual acuity, refraction, ocular alignment, stereopsis, corneal clarity, and corneal topography.

A total of 32 patients (mean age, 8.6±2.3 years; 50% boys and 50% girls) were included in the study. Patients had a mean preoperative spherical equivalent refraction of -10.3±2.0 D in the affected eye with an anisometropic difference of -9.5±1.7 D. The mean baseline best-corrected visual acuity (BCVA) in the affected eyes was 0.04±0.6 Decimal.

The investigators report that patients had a mean post-LASIK spherical equivalent refraction of -1.3±0.8 D (P <.001) and observed a significant decrease in anisometropia to 0.3±0.8 D at 6 months, 0.4±1.0 D at 1 year, and 1.0±2.5 D at 10 years (P <.001 for all). 

Relative to baseline BCVA, the team observed a significant improvement in BCVA to 0.6 ±0.2 after LASIK and occlusion therapy (P <.001). They also found patients maintained orthophoria, improved stereopsis, and clear cornea, and reported no evidence of post-LASIK ectasia.

“Visual outcomes were mostly better in younger children with better baseline BCVA and vice versa. It is well known that children within the critical period of visual development are more sensitive to amblyopia treatment, and this sensitivity gradually decreases thereafter when the visual maturation is complete and the visual centers become resistant to visual input,” according to the researchers. “[However,] pediatric candidates for LASIK refractive surgery should be carefully selected and LASIK procedure should be considered only when conventional measures have been exhausted, or chronic non-compliance or intolerance of conventional treatments endanger normal visual development.”