Refractive surgery for anisometropic amblyopia
Reviewed by Fiona Rowe

The authors report the outcomes of refractive surgery with phakic intraocular lens (PIOL) implant for management of anisometropic amblyopia in children intolerant to conventional therapy. This was a retrospective study of 71 eyes of 71 patients of which 58 were myopic anisometropia and 13 hypermetropic. Mean preoperative spherical equivalent of myopic eyes was -12.47 ±3.71D reducing to -0.73 ±0.52D at two - six years postoperative, p=0.01267. Mean preoperative spherical equivalent of hypermetropic eyes was +7.15 ±2.45D reducing to +0.94 ±0.68D, p=0.02383. Mean corrected distance visual acuity of all 71 eyes was 0.68 ±0.32 logMAR preoperatively, improving to 0.27 ±0.15 postoperatively. Sixty-nine percent gained ≥1 line of visual acuity and all gained gross stereoacuity. Complications included six patients with pupil ovalisation (all resolved) and two cases of endothelial cell loss due to problems with haptic release. There were no inflammatory reactions. Limitations were that this was a retrospective study. A strength was the large numbers included. The results indicate PIOL is an effective method to correct severe cases of anisometropia with potential to cause amblyopia in children refractive to typical therapy.

Anterior chamber iris-fixated phakic intra ocular lens implantation for treatment of high anisometropia in children; long-term results.
Griscikova L, Autrata R, Krejcirova I, et al.
JOURNAL OF PEDIATRIC OPHTHALMOLOGY AND STRABISMUS
2023;60(3):203-9.