Klinika ocni a esteticke chirurgie in Zlin, Czech Republic Authors: Katerina Buusova Smeckova, M.D., MBA As. professor Zdenek Smecka, M.D., CSc. None of the authors has a financial interest on presented data. 1ASCRS San Diego 2011
Purpose Retrospective study summarizing and comparing the change of BCVA between 2 groups of adult patients with amblyopia 3 months after the procedure. First group underwent a standard refractive lens exchange with the implantation of the premium IOL (AcrySof ReSTOR Aspheric SN6AD1). The second group underwent a standard excimer laser ablation with Carl Zeiss MEL 80 (either LASIK, PRK or Epi-LASIK). „In the absence of an organic lesion, a difference in BCVA of two Snellen lines or more (or >1 log unit) is indicative of amblyopia. „ Jack J. Kanski, Clinical Ophthalmology, 6th Edition, Butterworth Heinemann, 2007 ASCRS San Diego 20112
Setting / Venue ASCRS San Diego 20113
Methods Retrospective, non-randomised, unmasked study of 2 groups of 50 adult patients each with amblyopia (initial BCVA [0,1;0,7]). Each group was divided into 3 equal subgroups based on the severity of amblyopia. Prior the surgery Dsf, Dcyl, BCVA measurements and eye examination was performed. Group A underwent a standard uncomplicated bilateral RLE (one surgeon, one phaco device, 2,2mm incision, SN6AD1 IOL). Group B underwent a standard uncomplicated bilateral hyperopic excimer laser treatment (LASIK, Epi-LASIK, PRK, one surgeon, Carl Zeiss MEL 80). Outcome measurements have been performed 3 months after surgery: Dsf, Dcyl of a non-dominant eye and BCVA. Any complications were recorded. ASCRS San Diego 20114
Results I.: Change in BCVA IOL Excimer laser ASCRS San Diego % of eyes had postop. BCVA 1,0.8% of eyes had postop. BCVA 1,0.
Results II.: Change in BCVA- Subgroup BCVA less than 0,5 IOL Excimer laser ASCRS San Diego Average change of BCVA 0,35.Average change of BCVA 0,13.
Results III.: Subgroup BCVA equal to 0,5 IOL Excimer laser ASCRS San Diego Average change of BCVA 0,19.Average change of BCVA 0,11.
Results IV.: Subgroup BCVA more than 0,5 IOL Excimer laser ASCRS San Diego Average change of BCVA 0,08.Average change of BCVA 0,12.
Results V.: Total IOL Excimer laser ASCRS San Diego Average change of BCVA 0,15.Average change of BCVA 0,12.
Results VI. IOL Excimer Laser 10 BCVA before surgery BCVA 3M after Difference in BCVA Postop BCVA 20/20 8% 13% 0,12 difference 0,15 difference 0,60+/-0,23[0,1;1,0] 0,61+/-0,22[0,3;1,0] 0,46+/-0,16[0,1;0,7] 0,48+/-0,15[0,1;0,7 ]
Other correction means 1. Holmes, Repka, Kraker & Clarke (2006). "The treatment of amblyopia". Strabismus 2. Polat, U; Polat, Uri; Ma-Naim, Tova; Belkin, Michael; and Sagi, Dov (27 April 2004). "Improving vision in adult amblyopia by perceptual learning". PNAS ASCRS San Diego
Conclusions The probability of an improvement is in the inverse proportion to the initial BCVA. With the respect, that the vision may worsen (15%RLE, 5% laser) and that the probability of BCVA 20/20 is low- 13% (group-IOL), 8% (group-excimer laser), patients with amblyopia may benefit from both RLE and excimer laser treatment. 12ASCRS San Diego 2011