Analysis of profile of visual acuity changes following LaserAssisted Keratomileusis in adult amblyop

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Analysis of profile of visual acuity changes
following Laser-Assisted Keratomileusis in adult
amblyopia

• Kalyan Das MS, DNB
• Bobby Sarungbam MBBS
• Kasturi Bhattacharjee MS, DNB, FRCS
• Ranjay Chakraborty BS Opt
• Sri Sankaradeva Nethralaya, Guwahati, Assam,
  India
• Web www.ssnguwahati.org

No financial relationship with any product
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• Amblyopia is caused by two factors
• Loss of binocular function in central visual
  field
• Blurred imagery in the weak eye

Affects 2-5 of general population .1 50 of
all suspected cases of amblyopia caused by
anisometropia.
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• The recovery of vision tends to depend on the
  maturity of neural connections , length of
  deprivation , and at what age the therapy is
  begun.2

• Adult amblyopia exact prevalence is unknown

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Objective

• To evaluate,
• 1. Improvement in visual acuity after LASIK in
  adult patients with uniocular ametropic amblyopia
• To analyze,
• 2. The changes in post operative uncorrected
  visual acuity (UCVA) in different types and
  ranges of diopteric power

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Material and methodology

• Retrospective non comparative review.
• Procedure Laser Assisted In Situ Kerato -
  mileusis (LASIK)
• Lasers used Allegrato Wavelight I Q 400 Hz
• Pre LASIK test cycloplegic refraction and
  acceptance, topography, pachymetry, IOT, anterior
  segment and dilated fundus exam.
• Post LASIK test visual acuity measurement with
  snellens distant acuity chart, and topography

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• Inclusion criteria
• Adult patient age more than 14 years
• Only uniocular ametropic amblyopia
• Exclusion criteria
• Patients with sensory deprivation amblyopia
• Patients with other ocular pathology

Prior written permission taken before enrolment
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Types of refractive errors

• Compound myopic astigmatism - 14
• Compound hyperopic astig. - 10
• Simple myopic astigmatism - 1
• Simple hyperopia - 1
• Simple myopia - 1

Total eyes 27 Male 12 Female 15
Age range 14 to 35 years
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Myopia
10
3
3
2
X axis range of refractive error Y axis
number of patients
Hyperopia
0
2
9
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Post operative uncorrected visual acuity (UCVA)
Vs Pre operative best spectacle corrected
visual acuity (BSCVA)

• But post operative BSCVA attained the pre
  operative BSCVA level.

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UCVA is increased by at least 1 line in 9 out of
11 eyes (81.81)
Hyperopia
X axis range of refractive error Y axis
number of patients
UCVA is increased by at least 1 line in 5 out of
16 eyes (31.25)
Myopia
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Conclusion

• Improvement of Post operative UCVA (at least by
  one line of Snellens VA)
• In myopia - 31.25
• In hyperopia 81.81
• Overall - 51.84

LASIK offers better visual outcome in hyperopic
amblyopic of higher order
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• References
• 1. Flynn JT Amblyopia revisited. J Pediatr
  Ophthalmol Strabismus 1991 28183-201
• 2. Barret et al understanding the neural basis
  of amblyopia Neuroscientist 10(2)106-117,2004
• 3. Yen, Kimberly G. Amblyopia, E medicine,
  08/16/20041-12
• 4. Sakatani K et al Improvement in best
  corrected visual acuity in amblyopic adult eyes
  after laser in situ keratomileusis. JCRS 2005,
  Dec 31(12)2517

Thank You