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Klinika ocni a esteticke chirurgie in Zlin , Czech Republic

Alteration of the degree of amblyopia in adults after either a premium IOL implantation, or a hyperopic excimer laser treatment . Klinika ocni a esteticke chirurgie in Zlin , Czech Republic Authors : Katerina Buusova Smeckova , M.D., MBA As. professor Zdenek Smecka , M.D., CSc.

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Klinika ocni a esteticke chirurgie in Zlin , Czech Republic

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  1. Alteration of the degree of amblyopia in adults after either a premium IOL implantation, or a hyperopic excimer laser treatment Klinika ocni a esteticke chirurgie in Zlin, CzechRepublic Authors:KaterinaBuusovaSmeckova, M.D., MBA As. professor Zdenek Smecka, M.D., CSc. None of the authors has a financial interest on presented data. ASCRS San Diego 2011

  2. Purpose • Retrospective study summarizingandcomparing the change of BCVAbetween 2 groups of adult patients with amblyopia3 months after the procedure. • First group underwent a standard refractive lens exchange with the implantation of the premium IOL (AcrySofReSTOR Aspheric SN6AD1). • The second group underwent a standard excimer laser ablation with Carl ZeissMEL 80 (either LASIK, PRK or Epi-LASIK). „In the absence ofanorganiclesion, a difference in BCVA oftwoSnellenlinesor more (or>1 log unit) isindicativeof amblyopia. „ Jack J. Kanski, ClinicalOphthalmology, 6th Edition, ButterworthHeinemann, 2007 ASCRS San Diego 2011

  3. Setting / Venue ASCRS San Diego 2011

  4. Methods • Retrospective, non-randomised, unmasked study of 2 groups of 50 adult patients eachwith 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 wasperformed. • 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 ZeissMEL 80). • Outcome measurements havebeenperformed 3 months after surgery: Dsf, Dcyl of a non-dominant eyeandBCVA. Any complications wererecorded. ASCRS San Diego 2011

  5. Results I.: Change in BCVA 13% ofeyes had postop. BCVA 1,0. • 8% ofeyes had postop. BCVA 1,0. IOL Excimer laser ASCRS San Diego 2011

  6. Results II.: Change in BCVA- Subgroup BCVA lessthan 0,5 Averagechangeof BCVA 0,35. • Averagechangeof BCVA 0,13. IOL Excimer laser ASCRS San Diego 2011

  7. Results III.: Subgroup BCVA equal to 0,5 Averagechangeof BCVA 0,19. • Averagechangeof BCVA 0,11. IOL Excimer laser ASCRS San Diego 2011

  8. Results IV.: Subgroup BCVA more than 0,5 Averagechangeof BCVA 0,08. • Averagechangeof BCVA 0,12. IOL Excimer laser ASCRS San Diego 2011

  9. Results V.: Total Averagechangeof BCVA 0,15. • Averagechangeof BCVA 0,12. IOL Excimer laser ASCRS San Diego 2011

  10. Results VI.IOL Excimer Laser • 0,48+/-0,15[0,1;0,7] • 0,46+/-0,16[0,1;0,7] • 0,60+/-0,23[0,1;1,0] • 0,61+/-0,22[0,3;1,0] • 0,15 difference • 0,12 difference • 13%

  11. Othercorrectionmeans 1. Holmes, Repka, Kraker & Clarke (2006). "The treatment of amblyopia". Strabismus 2. Polat, U; Polat, Uri; Ma-Naim, Tova; Belkin, Michael; andSagi, Dov (27 April 2004). "Improving vision in adult amblyopia by perceptuallearning". PNAS ASCRS San Diego 2011

  12. 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. ASCRS San Diego 2011

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