Photorefractive keratectomy for pediatric myopic anisometropia

Purpose: To evaluate the visual results of excimer laser photorefractive keratectomy (PRK) to treat pediatric patients with amblyopic myopic anisometropia in whom conventional amblyopia treatments have failed. Setting: Institute Oftalmologico de Alicante, University of Alicante, Spain. Methods: Six patients aged 5 to 7 years with amblyopic myopic anisometropia were treated by PRK in the more myopic eye using a VISX Twenty-Twenty excimer laser. Minimum preoperative refraction in the amblyopic eyes ranged from -4.00 to -13.00 diopters and best corrected visual acuity (BCVA), from 20/40 to 20/400. All cases completed a minimum of 2 years follow-up of antiamblyopic treatment. Results: After PRK, preoperative BCVA was maintained without optical correction and complementary refraction resulted in increased BCVA in every case. One patient with high myopia developed severe haze. There were no other significant complications. Conclusion: Our results indicate that PRK may be an alternative for the correction of pediatric myopic anisometropia and an important aid in treating amblyopia. When other therapies have failed, using PRK in children of the ages in this study must be carefully evaluated, however, our results suggest a beneficial effect.