Long Term Efficacy Of Hyperopic Anisometropic Amblyopia Child And Adolescent After LASIK

Objective:To investigate the long-term clinical effect and the visual functionimprovement of LASIK on hyperopic anisometropic amblyopia in childrenand adolescents.Method:Choice75cases (75eyes) of hyperopic anisometropic amblyopia childrenand adolescents underwent LASIK operation in the Second Hospital of HebeiMedical University’s Excimer Laser Treatment Center from07.2008to08.2013, dividing them into the group of children and the group of adolescentby age. The group of children (sensitive period group) has20cases (20eyes), aged7to12years old, mean10.30±1.56years old. The group ofadolescent (after the sensitive period group) has55cases (55eyes), aged13to18years old, mean15.89±1.97years old.Give the group of children and the group of adolescent routinepostoperative treatment，including visual acuity，computer optometry，mydriasis optometry (Children with1%atropine ointment,3times a day andfor3days, optometry on the fourth days, optometry again after3weekswith small pupil; adolescents with1%Tropicamide Eye Drops,1times every5minutes for a total of4times, optometry after30minutes),best correctedvisual acuity, strabismus degree examination. And binocular visual functionexamination, including the vision, fusion, stereo vision etc. The group ofchildren’s preoperative visual acuity with an average of0.15±0.12, mean bestcorrected visual acuity was0.16±0.08, mean spherical lenswith was+6.04±1.53D, mean spherical equivalent was+6.59±1.47D, the contralateral eyesspherical equivalent average+1.14±1.40D, mean binocular anisometropiadegrees wsd5.69±1.15D, foveal stereoacuity，macular stereoacuity and peripheral stereoacuity were0cases (0%),0cases (0%),1cases (5%). Thegroup of adolescent’s preoperative visual acuity with an average of0.16±0.14, mean best corrected visual acuity was0.29±0.26,mean spherical lenswas+5.00±1.81D, mean spherical equivalent was+5.63±1.73D, thecontralateral eyes mean spherical equivalent was+0.15±1.57D, meanbinocular anisometropia degrees was5.60±1.53D,foveal stereoacuity, macular stereoacuity and peripheral stereoacuity were0cases (0%),1cases (1.82%),2cases (3.64%).The design of operation according to the refractive state and characteristicof children and adolescents, and all LASIK operations were performedby experienced physicians. Routine postoperative treatmens and amblyopiatraining were given after operation, and flup on the postoperative1day,1week,1month,3months,6months,1~5years. Flup treatmentsincluded postoperative visual acuity, computer optometry， mydriasisoptometry, best corrected visual acuity, and binocular visual functionexamination. Using SPSS16.0statistical analysis software to analysis theobservation indexes.Result:1The group of children: Postoperative visual acuity with an average of0.40±0.21, best corrected visual acuity for an average of0.46±0.19,4cases’(20%) best corrected visual acuity improved in5or5lines of the above,15cases’(75%) best corrected visual acuity improved in2or2lines of above,mean diopter was+0.43±1.05D, mean binocular anisometropia was0.96±0.63D, differences were statistically significant (P <0.05) compared with thepreoperative. Compared with the preoperative refraction, diopter is reduced byan average of6.27±1.33D, binocular anisometropia degree is reduced by anaverage of4.79±1.33D. To the last follow-up after operation, not foundthe refractive regression, the group of children’s foveal stereoacuity, macularstereoacuity and peripheral stereoacuity were1cases (5%),2cases(10%),4cases (20%).2The group of adolescent: Postoperative visual acuity with an average of 0.43±0.25, best corrected visual acuity for an average of0.53±0.24,12cases’(22%) best corrected visual acuity improved in5or5lines of theabove,39cases’(71%) best corrected visual acuity improved in2or2linesof above, mean diopter was+0.40±0.84D, mean binocular refraction was0.99±0.53D. Differences were statistically significant (P <0.05) compared withthe preoperative. Compared with the preoperative refraction, diopter is reducedby an average of5.23±1.85D, binocular anisometropia degree is reduced byan average of4.61±1.72D, the differences were statistically significant (P <0.05). To the last follow-up after operation, not found the refractiveregression,the adolescent group’s foveal stereoacuity, macular stereoacuity andperipheral stereoacuity were5cases (9.09%),4cases (7.27%),4cases(7.27%).3The postoperative observation indexes of the group ofchildren compared with the group of adolescent,including visual acuity, bestcorrected visual acuity and diopter have no statistical significance (P＞0.05).Conclusion:1LASIK for correcting hyperopic anisometropic amblyopia in child andadolescent is safe, effective and predictable.2Hyperopic anisometropic amblyopia in children and adolescent shouldbe found and treated early, to reduce the damage of vision, diopter andstereoscopic vision to a minimum.3Hyperopic anisometropic amblyopia adolescents after the sensitiveperiod,is still expected to improve vision, set up stereoscopic visionand improve the binocular visual function byLASIK operation and postoperative specification amblyopia training.4LASIK provides an effective method for correction of hyperopicanisometropic amblyopia children and adolescents,who are poorcompliance or ineffective of the traditional method.