Clinical evaluation of efficacy and prediction for refractive keratoplasty with hydrophilic copolymer explant for myopic anisometropia correction in children

    Purpose. To eliminate a high myopic anisometropia in children by means of refractive keratoplasty using an explant made of hydrophilic copolymer.

    Material and methods. Possibilities of refractive keratoplasty application with explant (RKPE) were studied in case of high myopic anisometropia in children. The RKPE surgery was performed in 36 patients (36 eyes), among them 26 girls (72.2%), 10 boys (27.8%).

    Results. In evaluation of results we took into consideration features of postoperative course, dynamics of visual acuity data, spherical equivalent (SE) of clinical refraction. Patients were divided into 2 groups for a higher objectivity of the study. The first group included patients with unilateral myopia (n-15), and the second group (n-21) — with bilateral myopia. In both groups it was noted that SE data postoperatively had a statistically significant difference decreasing compared with average preoperative values, and in the first group of patients - 4 times, in the second group — 2.8 times. At the same time the best corrected visual acuity (BCVA) increased in a higher rate of cases. Generally, the average data of postoperative uncorrected visual acuity (UCVA) and BCVA rose on an average by 82%.

    Conclusions. The application of refractive keratoplasty with an hydrophilic copolymer explant leads to a stable increase of visual acuity and a decrease of amblyopia degree. Elimination of the main cause of amblyopia promotes an improvement of visual functions even without its treatment. The study shows a high efficacy, a safety and a prediction of RKPE results in children.

    Key words: refractive keratoplasty, myopic anisometropia, spherical equivalent, best corrected visual acuity (BCVA), hydrophilic copolymer explant.