Long-term Outcomes of Femtosecond Laser-assisted Laser in situ Keratomileusis for Anisometropic Amblyopia in Children with Hyperopia

Abstract

Objective: analysis of remote clinical functional results of femtolaser-assisted laser in situ keratomileusis (FS-LASIK) in children with hyperopia and anisometropic amblyopia.Patients and methods: 30 children aged 5–13 (7.9 ± 2.3) years were in the study. FS-LASIK refined technology surgery was rendered to all children under general anesthesia at amblyopic eye, previously they had no success of conservative treatment. Mean spherical equivalent of refraction (SE) of amblyopic eye was +5,08 ± 1.64 D in conditions of cycloplegia. Mean SE anisometropia was 3,42 ± 1.92 D, difference in refraction between eyes was statistically significant (pmu = p < 0,001) in all patients. There was 43.3% of severe amblyopia, 56.7% cases of moderate amblyopia. General period of control was 5 years.Results: In 5 years after FS-LASIK SE of operated eye was +1.02 ± 0.28 D, predictability of refractive effect within ±0.5 D was 47%, ±1.0 D was 77% of cases. All patients gained 1–5 lines, UDVA was 0,5 and higher in 61% of cases. There were 6.7% of cases with moderate amblyopia, mild –80%, and amblyopia absence –13.3 % of cases. SE anisometropia decreased 2,37 ± 1.17 and was 0,18 ± 1.05 D, difference between operated and fellow eye was minor, but statistically significant (pmu = p < 0,05). Trend to myopisation of fellow eye was revealed.Conclusion: remote clinical functional results of FS-LASIK in correction of hyperopic anisometropia in children show safety and efficacy of interference. Refractive surgery in children should be considered not as an independent method of treatment, but in complex with conservative methods of amblyopia treatment.

Keywords

• femtosecond laser
• refractive surgery in children
• anisometropia
• amblyopia