Klinika ocni a esteticke chirurgie in Zlin, Czech Republic Authors: Katerina Buusova Smeckova, M.D.,...
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Transcript of Klinika ocni a esteticke chirurgie in Zlin, Czech Republic Authors: Katerina Buusova Smeckova, M.D.,...
ASCRS San Diego 2011 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, 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.
ASCRS San Diego 2011 2
PurposeRetrospective 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 2011 3
Setting / Venue
ASCRS San Diego 2011 4
MethodsRetrospective, 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 2011 5
Results I.: Change in BCVAIOL Excimer laser
0
0.2
0.4
0.6
0.8
1
1.2
BCVA preop. BCVA postop.
0
0.2
0.4
0.6
0.8
1
1.2
BCVA preop. BCVA postop.
13% of eyes had postop. BCVA 1,0.
8% of eyes had postop. BCVA 1,0.
ASCRS San Diego 2011 6
Results II.: Change in BCVA- Subgroup BCVA less than 0,5
IOL Excimer laserAverage change of BCVA 0,35. Average change of BCVA 0,13.
21%
7%
71%
Unchanged WorseImproved
11%
89%
Unchanged WorseImproved
ASCRS San Diego 2011 7
Results III.: Subgroup BCVA equal to 0,5
IOL Excimer laserAverage change of BCVA 0,19. Average change of BCVA 0,11.
21%
7%
71%
Unchanged WorseImproved
48%
4%
48%
Unchanged WorseImproved
ASCRS San Diego 2011 8
Results IV.: Subgroup BCVA more than 0,5
IOL Excimer laserAverage change of BCVA 0,08. Average change of BCVA 0,12.
8%
31%
62%
Unchanged WorseImproved
57%
43%
Unchanged WorseImproved
ASCRS San Diego 2011 9
Results V.: Total
IOL Excimer laserAverage change of BCVA 0,15. Average change of BCVA 0,12.
13%
13%
74%
Unchanged WorseImproved
46%
3%
50%
Unchanged WorseImproved
Results VI. IOL Excimer Laser
10
BCVAbefore surgery
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]
ASCRS San Diego 2011 11
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 2011 12
ConclusionsThe 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.