[Laser in situ keratomileusis for treatment of high hyperopic anisometropia in children].

OBJECTIVE

To assess the safety, efficacy, predictability and stability of the laser in situ keratomileusis (LASIK) procedure in high hyperopic anisometropia with amblyopia in pediatric patients and to study the effect of amblyopic therapy after the surgery.

METHODS

This is a prospective and self-control study which included 42 children with high hyperopic anisometropic amblyopia. The age of the children ranged from 6 to 14 years. LASIK was performed in the eyes with higher degree of hyperopic under topical or general anaesthesia using the Summit's SVS Apex plus (L mask for simple hyperopia, 9 eyes; P mask for hyperopia and astigmatism, 12 eyes) and the Lumenis's Allegretto Wave (21 eyes). Postoperative visual acuity, refraction and the binocular vision were analyzed. Minimum follow-up period was 6 months; 24 children had a 2-year follow-up.

RESULTS

In eyes with +3.00 diopters (D) to +7.50 D preoperatively, the postoperative refraction in 66.6% of eyes was within +/- 1.00 D of the expected correction. From 6 to 24 months postoperatively, there was a mean variation from +0.67 to + 0.99 D in cycloplegic equivalent refraction. Best spectacle-corrected visual acuity (BSCVA) of distance and reading did not decrease after the surgery. The mean BSCVA of distance was 0.40 +/- 0.28 (P < 0.001) and reading BSCVA was 0.78 +/- 0.39 (P < 0.001) 2 years after the surgery. Simultaneous vision, fusion, stereopsis and heterophoria were improved 2 years postoperatively.

CONCLUSIONS

LASIK is a safe and effective procedure for the correction of high hyperopic anisometropia in children who cannot tolerate contact lens. This procedure provides a satisfactory predictability and refractive stability results 2 years postoperatively. The effects of amblyopia therapy can be improved after the surgery.