Refractive surgery in patients with high myopic anisometropia.

摘要

PURPOSE: To assess the efficacy and safety of LASIK in patients with high myopic anisometropia and to provide specific screening guidelines for anisometropic patients undergoing refractive surgery. METHODS: Twenty-six eyes of 16 patients with high myopic anisometropia (>3.0 diopters) were enrolled in this study. Complete pre- and postoperative ophthalmologic and orthoptic examinations were performed. The preoperative orthoptic examination was done with glasses and contact lenses. Twenty-two eyes of 13 patients underwent uncomplicated LASIK; the second eye was treated 2 weeks after the first eye. Patients were examined 1 day, 7 days, and 1, 3, 6, and 12 months after surgery. RESULTS: Thirteen patients obtaining good results at red glass bar test (RGB) underwent LASIK without postoperative diplopia; four showed an improvement of the sensorial assessment. Three patients were excluded from surgery because of diplopia with RGB values <4 to 5. LASIK temporarily induced diplopia in the suppressed eye of one patient; however, the diplopia disappeared after surgery of the fixating eye. CONCLUSIONS: Patients with high myopic anisometropia and a weak sensorial state who undergo refractive surgery may be at risk for postoperative diplopia. We suggest clinical guidelines to reduce the occurrence of this complication.