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MA Leibole, GJ Berdy, E Packwood, A Norman, L Tychsen; Laser Refractive (LASEK and PRK) Surgical Correction of High Anisometropic Myopia in Amblyopic Children . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4134.
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Purpose: The purpose of the study was to determine if LASEK (laser sub-epithelial keratomileusis) and PRK (photorefractive keratectomy) are effective methods for correcting amblyogenic myopic refractive errors in children. Methods: Twenty-five amblyopic children, ranging in age from 5-16 yr old (mean 9.3 yr) received treatment in one eye for anisometropic myopia. Fifteen children (60%) had a neurobehavioral disorder and were non-compliant with spectacle or contact lens wear. The magnitude of the myopia ranged from -3.25 to -24.25 D (mean -11.48 D) and the amount of myopia corrected was tailored to match the refractive error of the fellow, non-amblyopic eye. The VISX Star S2 and S3 excimer lasers were employed in manual or auto-tracking modes, and stabile corneal centration was achieved in all children by use of I.V. propofol. general anesthesia. Mean follow-up was 9.1 mos (range 3-18 mos). Results: The amount of myopia corrected averaged 8.95 ± 2.89 D (range -3.25 to -15.50). Nineteen children (76%) were corrected to within ± 1.50 D of the goal refraction; 7% (2/25) to within 1.5-3.0 D of the goal, and the remaining 17% (4/25) fell more than 3.00 D outside the goal refraction (all undercorrected). Best-corrected visual acuity improved post-operatively in 84% (21/25), remained the same in 16% (4/25) and declined in 0%. Binocularity improved in 52% (13/25) and remained the same in 48%. Corneal haze measured grade 0-I in 72%, grade II in 20%, and grade III in 8%. No epithelial flap complications were encountered. Conclusion: Laser refractive surgery is an effective method for correcting anisometropic myopia in amblyopic children. Further study is indicated to determine the long-term stability and safety of the procedure in this population.
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