Laser in situ keratomileusis for treated anisometropic amblyopia in awake, autofixating pediatric and adolescent patients.
ABSTRACT To establish the safety and efficacy of laser in situ keratomileusis (LASIK) in pediatric and adolescent patients with anisometropic amblyopia who completed amblyopia therapy and had a visual acuity of 20/30 or better bilaterally.
Department of Ophthalmology and Visual Science, University of Texas-Houston Medical School, Houston, Texas, USA.
From August 2000 to March 2002, LASIK was performed in 21 eyes of 19 consecutive patients meeting eligibility requirements. The procedure was performed with the Summit Autonomous LADARVision 4000 excimer laser (Alcon Laboratories, Inc.) in the amblyopic eye for the correction of anisometropia or in both eyes. All patients were awake and autofixating during the procedure.
The mean patient age was 13.14 years (range 8 to 19 years). Seventeen patients were treated in the amblyopic eye only to correct anisometropia; treatment was performed in both eyes of 2 patients who were older than 18 years. Patients were followed for a mean of 18.0 months (range 8.6 to 26.5 months). Anisometropia was greater than 2.00 diopters (D) in all cases (mean 4.43 D, range 13.25 to 2.25 D). The percentage deviation from the attempted correction in the myopic group was 4.0% +/- 4.0% (SD) (range 2.0% to 10.0%) and 38.0% +/- 13.0% (range 5.0% to 58.0%) in the hyperopic group. Anisometropia decreased uniformly to less than 2.00 D in all patients (mean 1.52 D). The percentage of patients with stereo acuity increased from 63.0% preoperatively to 84.0% postoperatively.
Laser in situ keratomileusis safely and effectively reduced anisometropia in these patients. If stereo acuity is not possible preoperatively, it may be obtained postoperatively.
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ABSTRACT: Correction of refractive errors can be achieved with spectacles, contact lenses, and refractive surgery. The past decade has seen a surge in the availability of alternatives for patients and surgeons in terms of both surgical and nonsurgical options for the management of refractive errors. Newer generation contact lenses provide enhanced safety and better handling, whereas modern-day refractive surgery presents a plethora of choices based on the clinical characteristics and requirements of patients. We have moved from an era of "one size fits all" to a purely customized way of treating patients with refractive errors. This review presents the background, advantages, and disadvantages of the two most commonly used options for correction of ametropia, ie, contact lenses and refractive surgery.Clinical Optometry. 01/2011; 3:63-72.
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ABSTRACT: To propose a comprehensive classification of anisometropia, a method to calculate the theoretical related aniseikonia (objective aniseikonia) and a purpose-designed eikonometer to measure aniseikonia psychophysically (subjective aniseikonia). University Hospital Antwerp, Department of Ophthalmology, Edegem, Belgium. The occurrence of anisometropia was evaluated in 263 patients scheduled for cataract surgery. Subjective aniseikonia was evaluated in 77 healthy patients. The theoretical model was validated to calculate objective aniseikonia by implementing data from the literature. Ultimately, an aniseikogram was developed and its practical use illustrated by 4 clinical cases of anisometropia. In a population of 263 patients, the total incidence of anisometropia was 7.6%, with a dominance of axial anisometropia. Subjective aniseikonia between 2% and 4% was found in 3.0% to 7.5% of the cases, depending on the refractive error. The correlation coefficient between objective and subjective aniseikonia was good (R(2) = 0.82). Analysis of 4 clinical cases illustrated the calculated preoperative and postoperative aniseikonia in 4 types of anisometropia planned for lens removal. Anisometropia is not a rare condition and should be assessed before cataract surgery. A comprehensive method to calculate the objective aniseikonia and to measure the subjective aniseikonia in anisometropia was proposed. If cataract surgery is considered in anisometropic patients, a postoperative aniseikonia of 4% or more may be induced in the case of emmetropization. A method to calculate the intraocular lens power resulting in an acceptable postoperative aniseikonia, especially in axial anisometropic patients, is also proposed.Journal of Cataract [?] Refractive Surgery 08/2008; 34(8):1353-61. · 2.26 Impact Factor
Article: The ocular biometric and corneal topographic characteristics of high-anisometropic adults in Taiwan.[show abstract] [hide abstract]
ABSTRACT: To investigate the difference of ocular biometric and corneal topographic characteristics between the two eyes in high anisometropes with difference of 4 D or more in spherical component. Fifty-one young anisometropic men were collected. Detailed ocular examinations, including cycloplegic autorefraction, best-corrected visual acuity, intraocular pressure, A-scan, and Orbscan topography were done and recorded. The comparisons between two eyes were performed and the correlations between different ocular parameters were evaluated. The mean axial length in the more myopic/less hyperopic eye was longer than that in the less myopic/more hyperopic eye [difference 1.8 mm, 95% confidence interval (CI) 1.6-2.0 mm, p < 0.001]. The mean thinnest corneal thickness in the more myopic/less hyperopic eye was an average of 4.0 μm thicker than that in the other eye (95% CI 1.2-6.8 μm, p = 0.007). The mean anterior chamber depth in the more myopic/less hyperopic eye was an average of 0.05 mm (95% CI 0.02-0.07 mm, p < 0.001) more than that in the other eye. The curvature and size of cornea were not significantly different. The anterior chamber depth is deeper, axial length is longer, and thinnest corneal thickness is thicker in the more myopic/less hyperopic eye of high-anisometropic patients. Anisometropic eyes provide the chance to understand the biometric changes of eyeball with different refractive statuses in the same person. Such information is helpful for us to calculate the intraocular lenses power in cataract surgery and to do the surgical planning for corneal refractive surgery in eyes of different refractive power.Journal of the Chinese Medical Association 07/2011; 74(7):310-5. · 0.79 Impact Factor