Study shows lasers safely and effectively treat eye conditions in children

The first study to document the safety and effectiveness of the use of excimer lasers to treat a variety of eye maladies in children was published today in the September edition of the Journal of Cataract & Refractive Surgery.

The primary purpose of the study was to evaluate the safety and effectiveness of procedures using excimer lasers (phototherapeutic keratectomy, PTK, or photorefractive keratotomy, PRK, with PTK) to improve vision and reduce or eliminate pain, tearing, and excessive sensitivity to light in children who ranged from 8 years to 18 years. The study is significant because it followed a fairly large number of patients, 41 children (41 eyes), for a relatively long period, an average of 5 years after their operations. The excimer lasers are of the same type used to perform LASIK and other vision correction procedures in adults.

"This study indicates that lasers are offering pediatric ophthalmologists the ability to treat a variety of eye conditions with greater precision and control than are afforded by traditional means," said M. Edward Wilson, MD, chairman of the Pediatric Clinical Committee of the American Society of Cataract and Refractive Surgery, and chairman of the Department of Ophthalmology at the Storm Eye Institute at the Medical University of South Carolina.

"The traditional way of removing scars and calcifications on children's corneas (the clear, outermost part of the eye) involves the manual scraping or debriding of the cornea with ophthalmic instruments," Wilson said. "Lasers allow the removal of tissue by ablating it with a precision that can be measured in thousandths of a millimeter, a definite improvement over manual techniques," he said.

"The reason that we have been cautious in adopting lasers to treat pediatric conditions reflects the extreme caution physicians use in treating children. This study is important because it demonstrates the long-term safety and effectiveness of lasers in these applications," he added.

The study notes that an excimer laser was also used to treat a painful condition in which the surface cells of the cornea erode and fail to grow back properly. In such cases, the laser successfully stimulates normal cell growth. Other applications of the laser included correcting vision in children who had cataract surgery, among others.

The eye maladies resulted from a number of causes including infections, injuries and side effects of other treatments.

Results: Vision in all 41 children improved, and episodes of pain or discomfort, excessive tearing, and sensitivity to light diminished. One measure of vision improvement is the ability to read lines of letters on the standard (Snellen) eye chart. Follow-up evaluations of the children found that 8 had gained the ability to read 5 or more Snellen lines, 11 gained 4 lines, 9 gained 3 lines, 7 gained 2 lines, and 4 gained 1 line in comparison to their preoperative tests. One child was unchanged, and no one lost visual acuity.

"Phototherapeutic Keratectomy in Children: 5-Year Results," is by Rudolf Autrata, MD, PhD; Jaroslav Rehurek, MD, PhD; and Kristina Vodickova, MD. The study was performed at the Department of Ophthalmology of the Masaryk University Hospital in Brno, Czech Republic.

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