Pediatric refractive surgery: Corneal and intraocular techniques and beyond
ABSTRACT Refractive surgery has now been used successfully to treat severe anisometropia and isoametropia associated with amblyopia in children who cannot wear standard spectacles or contact lenses. Extraocular techniques include photorefractive keratectomy, laser-assisted subepithelial keratomileusis, and laser-assisted in situ keratomileusis. Intraocular techniques include refractive lensectomy and phakic intraocular lenses and are still being investigated in children for refractive errors outside the treatment dose capabilities of the excimer laser. This workshop discusses the various techniques, how and when to use each, and their risks and benefits. Newer techniques currently being used in adults that may someday be used in children are also introduced.
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ABSTRACT: Refractive laser surgery has become one of the most successful and commonly performed elective ophthalmic procedures. Since the introduction of photorefractive keratectomy, followed closely by the advent of laser in situ keratomileusis, the field of laser refractive surgery has continued to rapidly evolve. Surgical techniques are constantly refined to improve patient outcomes and minimize complications, and technology continues to advance to provide more precise and customizable treatment options. New applications of refractive procedures continually emerge in the literature. Breakthroughs in the field have led to novel applications of refractive procedures that may offer options to patients that previously had been considered poor surgical candidates. It is important for the clinician to maintain awareness of the current trends and new developments in refractive surgery to provide appropriate counseling and treatment for their patients.03/2013; 1(1). DOI:10.1007/s40135-012-0004-y
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ABSTRACT: To assess the effects of glasses for anisometropia on stereopsis and to determine the factors that affect the level of stereopsis. Retrospective observational case series. One hundred six nonamblyopic patients who were wearing glasses for anisometropia and 56 who were wearing glasses for isoametropia were enrolled. The levels of stereopsis in the anisometropic patients were divided into normal (≤40 seconds of arc), equivocal (40 < - ≤ 100), and subnormal (100 < - ≤ 400) and compared with those in the isoametropic patients. It was evaluated whether the amount of interocular difference in the lens power of the glasses, the type of anisometropia, a history of amblyopia, and the age at the time of the prescription of the first glasses were related to the stereopsis. In the anisometropia, the mean stereopsis (seconds of arc) was 77.52 (40-200) in the Titmus-fly test and 52.78 (40-100) in the Randot stereotest. The rate of normal and equivocal stereopsis was 87.7% in the Titmus-fly test and 96.9% in the Randot stereotest. The isoametropic patients demonstrated better stereopsis (52.86 and 39.20 in either test) than did the anisometropic patients (P < .05). The stereopsis was worse in the spherical hyperopic type of anisometropia than in the spherical myopic type (P < .05). The level of stereopsis was not related to the other factors that were investigated. The level of stereopsis with the wearing of anisometropic glasses was clinically near normal and the glasses did not seriously affect the binocular vision regardless of the severity of the anisometropia.American Journal of Ophthalmology 09/2013; DOI:10.1016/j.ajo.2013.07.016 · 4.02 Impact Factor
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ABSTRACT: Myopia is the commonest ocular abnormality and the high and growing prevalence of myopia, especially but not only in Asian populations, as well as its progressive nature in children, has contributed to a recent surge in interest. Such worldwide growing prevalence seems to be associated with increasing educational pressures, combined with life-style changes, which have reduced the time that children spend outdoors. Highly nearsighted people are at greater risk for several vision-threatening problems such as retinal detachments, choroidal neovascularization, cataracts and glaucoma, thus the potential benefits of interventions that can limit or prevent myopia progression would be of remarkable social impact. Our understanding of the regulatory processes that lead an eye to refractive errors is undoubtedly incomplete but has grown enormously in the last decades thanks to the animal studies, observational clinical studies, and randomized clinical trials recently published. In this review we assess the effects of several types of life-style and interventions, including outdoor activities, eye drops, undercorrection of myopia, multifocal spectacles, contact lenses, and refractive surgery on the onset and progression of nearsightedness.International Ophthalmology 09/2013; 34(3). DOI:10.1007/s10792-013-9844-1 · 0.55 Impact Factor