Photorefraction Keratectomy in High Myopic Anisometropia in Children

Overview

The authors evaluate the results of photorefractive keratectomy in children withhigh myopic anisometropia proved by intolerance of a contact lens and intoleran-ce of full correction by glasses. The objective was to maintain or improve thealready achieved binocular vision without or with feasible correction by glasses.The group is formed by 13 children, mean age 11.5 years at the time of surgery(range 7-15 years). The mean preoperative value of myopia was -8.9dpt (SE), withinthe range of -7.0 to -11.75 dpt (SE) on the operated eye. The preprequisite conditionfor surgery was confirmed intolerance of a contact lens , intolerance of completecorrection by glasses and previous systematic pleoptic treatment with training ofbinocular functions. The operation was always implemented during hospitaliza-tion.The follow-up after surgery in all children of the group is more than 2 years.The mean value of the refraction defect two years after surgery is -1.12 dpt (SE).The mean non-corrected visual acuity improved from 0.021 before surgery to 0.48two years after surgery and the mean best corrected visual acuity improved from0.51 before surgery to 0.61 two years after surgery. The authors compare resultsof binocular functions before and after operation. Two years after surgery allchildren had superposition and a normal Bagolini test, 12 children had fusion I,9 children fusion II, and 6 children fusion III and stereopsis. Based on the resultsof the trial PRK appears to be an effective and safe method for correction of highmyopic anisometropia in intolerance of contact lenses or complete correction byglasses. This operation thus makes it possible to preserve further the degree of binocular vision practised in advance or to improve it. This is the first group,though small, of thus treated children published in our professional literature.

Key words:
photorefraction keratectomy, myopia, anisometropia, children