Childhood anisometropic myopia corrected with excimer laser surgery

WASHINGTON — Laser surgery can correct anisometropic myopia in children with amblyopia, according to a surgeon speaking here at the American Association of Pediatric Ophthalmology and Strabismus meeting. Myopic regression is common postoperatively, however, he added.

Lawrence Tychsen, MD, and colleagues at St. Louis Children’s Hospital at Washington University Medical Center performed unilateral refractive corneal surface ablation in 36 children with myopia ranging from 3.5 to 24.25 D. The children had neurobehavioral disorders and were noncompliant with spectacle or contact lens wear.

For laser epithelial keratomileusis (LASEK) or photorefractive keratectomy surgery, the epithelial layer of the cornea was scraped off with a blunt or hook knife, and surface ablation was performed with the Visx Star S2/S3 excimer laser. Postoperative healing of the epithelial surface was complete in 3.5 days, and no patient developed lamellar keratitis.

Myopic correction was tailored to match the refractive error of the patient’s nonamblyogenic eye. Ninety-two percent of patients achieved correction within 1.5 D of their goal refraction. Regression of myopia of up to 1 D per year was experienced in 69% of patients following surgery.

Dr. Tychsen said these regression outcomes were comparable to those in previous studies of refractive surgery in children.

“Myopia regression is a drawback of this type of surgery,” he said. “So we need to find a way of impeding regression in this age group.”

Further study is needed to evaluate the risks and determine the long-term efficacy of refractive surgery in children, he said.