Techniques in pediatric refractive surgery.

Pediatric refractive surgery treats refractive errors and their associated comorbidities such as amblyopia and strabismus in special needs children intolerant of spectacles or contact lenses. Children with neurobehavioral disorders undergoing refractive surgery have improvements in visual acuity, communication, socialization, motor skills, adaptive behaviors, visual perception, and cognitive function. Contrary to adults, amblyopia is frequently an indication for refractive surgery in special needs children. Pediatric refractive surgery techniques modify ametropia at the corneal, anterior chamber, posterior chamber, and lens planes. This article will discuss the most common modalities used today in pediatric refractive surgery, including laser keratorefractive surgery, phakic intraocular lenses, and refractive lens exchange. Practical pearls are discussed for the implementation of pediatric refractive surgery, reviewing preoperative diagnostics, surgical techniques, and postoperative care.