V4B implantable collamer lens versus Intacs corneal rings to manage anisometropic myopic amblyopia in children.

OBJECTIVE: To compare the safety and efficacy of phakic intraocular lens (PIOL) versus intrastromal corneal ring segments (Intacs), for correcting high myopic anisometropia in amblyopic children. DESIGN: Nonrandomized prospective multi-center study. PARTICIPANTS: Thirty children, aged between 4 and 12 years, with unilateral high myopic anisometropic amblyopia were included in this study. METHODS: Patients who were prospectively subdivided into group A, with mean preoperative manifest refraction spherical equivalent (MRSE) of -12.96 ± 4.17 D, underwent unilateral phakic posterior chamber intraocular lens implantation. Patients with mean preoperative MRSE of -8.60 ± 1.16 D in group B were treated by Intacs corneal rings. Pre- and postoperative visual acuity, ocular examination, stereoacuity, axial biometry measurements, cycloplegic refraction, and endothelial cell counts were performed in all patients. RESULTS: Group A revealed prevention of amblyopia with improvement in spectacle-corrected distance visual acuity, where 4-6 lines were achieved in 77% of children, 2-3 lines in 4%, and just 0-1 lines restricted to 19% of children. Improvement in stereoacuity was noted in 93.33% of group A cases, whereas group B showed fewer cases of successfully improved vision, with 4-6 lines in 70% of children, 2-3 lines in 3%, and just 0-1 lines restricted to 27% of children. Improvement in stereoacuity was noted in 86.66% of cases. Two cases of cataract and 1 case of glaucoma with 1 case of uveitis were noted in the implantable contact lens (ICL) group. CONCLUSIONS: Posterior chamber PIOLs or Intacs may provide a safe alternative in treating anisometropic myopic patients. Intacs implantation is safer with fewer complications than ICL. However, ICL implantation is advantageous over the corneal ring segment procedure owing to the wide range of errors to correct.

Phototherapeutic keratectomy outcomes in superficial corneal opacities.

PURPOSE: COMPARE THE EFFECTIVENESS OF PHOTOTHERAPEUTIC KERATECTOMY (PTK) IN TREATMENT CORNEAL DYSTROPHIES VERSUS SUPERFICIAL CORNEAL SCARS: visual outcomes, recurrence rate and safety profile. METHODS: PTK was performed in 51 eyes of 51 patients. Data regarding the indications for PTK, ablation depth, symptomatic relief, pre-and postoperative best spectacle-corrected visual acuity (BSCVA), spherical equivalent changes, recurrence and complications were analyzed. The indications for PTK in our study were classified into two categories - group A: patients with corneal dystrophies (n = 23) and the other group B (n = 28) with other indications. RESULTS: The average age of the patients was 47 years (±16.4). The mean follow up period was 15.16 months (±10.01 months). Post operatively, there were no significant complications. While the overall BSCVA in the patients improved from 20/41 (0.484) to 20/32 (0.645), group A showed improvement from 20/35 (0.561) to 20/29 (0.687), as compared to group B in which BSCVA improved from 20/47 (0.421) to 20/33 (0.611). The most common indication in group A was granular corneal dystrophy (n = 10) and the most common indication in group B was post traumatic/infectious corneal scar or opacity (n = 10). Eighty-six percent (n = 44) of all patients had alleviation of symptoms. Recurrence of symptoms was seen in 3 eyes of recurrent corneal erosions which required retreatment. CONCLUSION: PTK is a safe and effective procedure. The outcome of this study suggests that PTK improves BSCVA. PTK appears to improve ocular surface health. Furthermore, PTK can be recommended to most patients with corneal dystrophies as a treatment modality prior to other more invasive procedure (viz. penetrating keratoplasty).