To evaluated the safety, efficiency, predictability and short term stability and also binocularity and streoscopic results of photorefractive keratectomy (PRK) for anisomyopia, anisohyperopia and anisoastigmatia in children with various levels of amblyopia secondary to anisometropia who were non compliant with glasses.

: A total of 12 consecutive eyes of 12 children with monocular amblyopia were enrolled in this study. Principal outcome measures included postoperative best-corrected and uncorrected visual acuity (BCVA, UCVA), postoperative refractive error, stereopsis, postoperative binocularity, corneal haze, and other complications. Treatment was tailored to match the spherical refractive error of the non-amblyopic eye and the target refraction was considered acceptable within 1 D of spherical equivalent (SE) of the fellow eye.

The mean age of the study population was 8.8±3.1 years (range, 6-17 years). Of the 12 patients included in the study, 8 (66%) were male . Preoperatively, the mean BCVA was 0.34±0.24 logMAR (range 1.0 to 0.1). It decreased to 0.35±0.23 at 1 month, but progressively increased to 0.26±0.18, 0.21±0.18 and 0.20±0.19 at 3 months, 6 months and 12 months, respectively. The improvement of BCVA at 6 and 12 months was statistically significant in comparison to preoperative period(p=0.003). The mean preoperative stereopsis was 341.9±245 seconds of arc improved to 166.6±87.5 that was statistically significant (p=0.012). Postoperatively, the mean SE refraction of anisoastigmatism, anisomyopic, hyperopic eyes were changed to -0.50±0.35 D, -0.25±0.43 D, +2.32±1.84 D after 12 months, respectively.

In this study, the results showed the efficacy of refractive surgery in treating anisometropic amblyopia in children non-compliant with glasses wear. The option of pediatric refractive surgery is an evolving field with sensitive issues. Refractive surgery in pediatric population can be an alternative in selected groups of amblyopic patients, but is still experimental and remains to be accepted as a first-line treatment option.