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

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.

Adult amblyopia – exact prevalence is unknown 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

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

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 snellen’s distant acuity chart, and topography

Adult patient – age more than 14 years 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

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

Myopia 10 3 3 2 X axis – range of refractive error Y axis – number of patients Hyperopia 2 9

Number of eyes % Post op. UCVA 8 29.62 1 line improvement 3 11.11 Post operative uncorrected visual acuity (UCVA) Vs Pre operative best spectacle corrected visual acuity (BSCVA) Number of eyes % Post op. UCVA 8 29.62 1 line improvement 3 11.11 2 line 3 line unchanged 5 18.51 1 line decreased* * But post operative BSCVA attained the pre operative BSCVA level.

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

Conclusion Improvement of Post operative UCVA (at least by one line of Snellen’s VA) In myopia - 31.25% In hyperopia – 81.81% Overall - 51.84% LASIK offers better visual outcome in hyperopic amblyopic of higher order

3. Yen, Kimberly G. Amblyopia, E medicine, 08/16/2004:1-12 References: 1. Flynn JT: Amblyopia revisited. J Pediatr Ophthalmol Strabismus 1991; 28:183-201 2. Barret et al : understanding the neural basis of amblyopia; Neuroscientist 10(2):106-117,2004 3. Yen, Kimberly G. Amblyopia, E medicine, 08/16/2004:1-12 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