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Anisometropic Amblyopia: The Potential Role of Keratorefractive Surgery

Correspondence: Requests for reprints should be addressed to: Evelyn A. Paysse, M.D., Baylor College of Medicine, Texas Children's Hospital, 6621 Fannin, MC 640.200, Houston, TX 77030; e-mail: epaysse{at}bcm.edu

Introduction: Traditional therapy for anisometropic amblyopia often fails when severe anisometropia is present. Recent advances in refractive surgery for anisometropic amblyopia suggest that surgical treatment may be a viable alternative in certain situations.

Methods: The potential indications for refractive surgery for anisometropia, the different refractive procedures available, and the risks and benefits of each procedure are discussed.

Results: The most reasonable indication at present is severe anisometropia that is nonresponsive to conventional therapy. The risks, though rare, of PRK and LASEK are corneal haze and regression of refractive correction, and risks of LASIK are keratectasia, flap loss, flap tear, or buttonhole, and regression of refractive correction.

Conclusions: Surgical interventions now exist that have value in the treatment of anisometropic amblyopia. Randomized clinical trails are needed in order to optimally evaluate the long-term safety and efficacy of these treatments.

Key words: anisometropic amblyopia, LASIK, LASEK, PRK, surgery, clear lens extraction