Laser-assisted subepithelial keratectomy for bilateral hyperopia and hyperopic anisometropic amblyopia in children: one-year outcomes.

PURPOSE

To assess the refractive, visual acuity, and binocular results of laser-assisted subepithelial keratectomy (LASEK) in children with bilateral hyperopia or hyperopic anisometropic amblyopia.

SETTING

Nonhospital surgical facility and hospital clinic, Calgary, Alberta, Canada.

METHODS

This retrospective review comprised children with bilateral hyperopia or hyperopic anisometropic amblyopia who had LASEK. Refractive status, visual acuity, and binocular vision were assessed and recorded 2 months and 1 year postoperatively.

RESULTS

The mean spherical equivalent (SE) in all 72 hyperopic eyes (47 patients) was +3.42 diopters (D) (range 0.00 to +12.50 D) preoperatively and +0.59 D (range -1.25 to +2.00 D) 1 year postoperatively. After LASIK, 41.7% of eyes had improved corrected distance visual acuity (CDVA). No patient had reduced CDVA or loss of fusional ability; there was a 25.0% improvement in stereopsis at 1 year. The mean anisometropic difference in the hyperopic anisometropic amblyopia subgroup (18 eyes, 10 patients) was 4.39 D (range +1.75 to +7.75 D) preoperatively and +0.51 D (range 0 to +0.875 D) at 1 year. One year postoperatively, 83% of anisometropic eyes were within +/-1.00 D of the fellow eye and 94.0% were within +/-3.00 D. Postoperatively, 64.7% of eyes had improved CDVA with no reduced CDVA or loss of fusional ability; there was a 22% improvement in stereopsis at 1 year.

CONCLUSION

Laser-assisted subepithelial keratectomy improved visual acuity in pediatric hyperopia with or without associated hyperopic anisometropic amblyopia.