The Experimental And Clinical Study Of Laser In Situ Keratomileusis For Anisometropic Amblyopia In Children

Purpose To assess the safety, efficacy, predictability and stability of the Laser in Situ Keratomileusis(LASIK)procedure in anisometropia with amblyopia in children and to study the effect of amblyopic therapy after surgery.In this report, we also try to study the response of corneal stroma and the healing mechanism of corneal wound after laser in situ keratomileusis.Methods This prospective, noncomparative interventional case series studied 32 children with high myopic anisometropic amblyopia and 42 children with high hyperopic anisometropic amblyopia in clinical study. LASIK was performed in the serious ametropic eyes under topical or general anesthesia using the Summit's SVS Apex plus excimer laser and the Lumenis's Allegretto Wave excimer laser. After surgery, all children undertake canonical ametropic therapy, and the postoperative visual acuity, refraction and binocular vision outcomes were analyzed. The follow-up time was from 6 months to 3 years.In experimental study, twenty-four immature rabbits and twenty-four adult rabbits were included. LASIK was performed on the right eye of the rabbits. The corneal specimen was prepared at the 10th, 30th, 90th and 180th day. The pathological changes of corneal were studied with routine histological and immunohistochemical staining. The expression changes of collagenⅢ, PCNA and transforming growth factorβ1 were analyzed.Results In clinical study, the mean preoperative cycloplegic spherical equivalent (SE) refraction of the operative eyes was -10.30 diopters(D)±2.95(SD)(range -17.25 to -4.62D)and the mean postoperative SE was -1.63 diopters(D)±1.81(SD)(range -4.50 to +0.87D)(P <0 .01) at 3 years after surgery in myopic groups. There was no loss of best spectacle-corrected visual acuity (BSCVA) of distance and reading, and the mean BSCVA of distance was 0.59±0.28(p<0.001)and the mean BSCVA of reading was 0.96±0.35(p<0.001)at 3 years after surgery. The proportion of patients who gained stereopsis was more than 73% at 3 years postoperatively. The percentage of eyes which aniseikonia were 4~8% decreased, and no one's aniseikonia was >8% in 36 months after...