Photorefractive Keratectomy in Treatment of Refractive Amblyopia in the Adult Population

Journal of Cataract & Refractive Surgery

Nurullah Cagil, Nagihan Ugurlu, Hasan Basri Cakmak, Sucattin Ilker Kocamis, Dervis Turak, Saban Simsek   

37(12): 2167-2174 December 2011

Purpose
To evaluate changes in corrected distance visual acuity (CDVA) after photorefractive keratectomy (PRK) in amblyopic cases.

Setting
Ankara Ataturk Training and Research Hospital 1st Ophthalmology Clinic, Ankara, Turkey.

Design
Retrospective case series.

Methods
The medical records of cases of anisometropic amblyopia treated by excimer laser PRK were reviewed. Inclusion criteria were no previous refractive correction, occlusion treatment, or chemical penalization before age 15 years. Anisometropic amblyopia was defined as a more than 2-line difference in CDVA and a refractive error difference greater than 3.00 diopters (D) between 2 eyes of the same patient. Final visual acuity measurements were performed at the end of the sixth postoperative month.

Results
The study enrolled 16 hyperopic patients and 34 myopic patients with a mean age of 33.3 years. The mean preoperative spherical equivalent was −7.46 D ± 2.90 (SD) in myopic eyes and +4.15 ± 2.56 D in hyperopic eyes. The differences between the preoperative and postoperative uncorrected distance visual acuity and CDVA were statistically significant (P=.001). The mean CDVA was 0.47 ± 0.17 preoperatively and 0.61 ± 0.19 postoperatively. The CDVA decreased in 3 cases (6%), stayed the same in 12 cases (24%), and increased in 35 cases (70%). There was no statistically significant correlation between the severity of amblyopia and the increase in CDVA (r = 0.20, P=.165).

Conclusion
After PRK to eliminate and correct refractive errors in anisometropic amblyopia, visual acuity improved significantly in 70% of adult patients with no previous occlusion or chemical penalization treatment.

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