Clinical results of excimer laser photorefractive keratectomy for high myopic anisometropia in children: four-year follow-up.

PURPOSE

To evaluate the visual and refractive results of multizonal photorefractive keratectomy (PRK) for high myopic anisometropia and contact-lens intolerance in children.

SETTING

Department of Ophthalmology, Masaryk University Hospital, Brno, Czech Republic.

METHODS

Twenty-one patients aged 7 to 15 years with high myopic anisometropia had multizonal PRK in the more myopic eye and were retrospectively analyzed. The scanning-slit Nidek EC-5000 excimer laser was used. Postoperatively, patients were reviewed at 1 and 3 days, 1 week, and 1, 3, 6, 12, 18, 24, 36, and 48 months. The examination included cycloplegic refraction, uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), biomicroscopy, grading of postoperative haze, corneal topography, pachymetry, intraocular pressure, biometry, orthoptic status, binocular vision (BV), and fundus evaluation. The safety, efficacy, predictability, and stability of the procedure were evaluated. Long-term binocular vision outcome was analyzed. All patients completed a 4-year follow-up.

RESULTS

The mean preoperative spherical equivalent (SE) refraction was 8.93 diopters (D) +/- 1.39 (SD) (range -6.75 to -11.75 D) and the mean postoperative SE, -1.66 +/- 0.68 D (range -0.50 to -2.75 D) (P <.05). The mean preoperative UCVA of 0.034 +/- 0.016 increased to 0.35 +/- 0.15 (P <.05) postoperatively. The mean preoperative BSCVA was 0.53 +/- 0.19 and changed to 0.64 +/- 0.16 postoperatively. The safety index was 1.21. No eye lost a line of BSCVA; 9 eyes gained 1 line, and 5 eyes gained 2 lines. The efficacy index was 0.66. The postoperative uncorrected and best spectacle-corrected BV were the same or improved. No eye had +3 haze. There were no significant complications.

CONCLUSIONS

Photorefractive keratectomy was safe and effective in correcting high myopic anisometropia in children who were contact-lens intolerant. It provided good visual results and preserved or improved BV over the 4-year follow-up.