1. 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
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2. 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.

3. 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

4. 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

5. 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

6. 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

7. Types of refractive errors:
Compound myopic astigmatism - 14
Compound hyperopic astig
Simple myopic astigmatism
Simple hyperopia
Simple myopia
Total eyes : 27
Male : 12
Female : 15
Age range: 14 to 35 years

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

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.

10. 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

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

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