Laser Surgery for Unilateral Amblyopia

A retrospective review compiled by Orucoglu et al from Hadassah - Hebrew University Medical Center, Israel (I Refract Surg 2011),  indicates that laser refractive surgery may be a good option for patients with mild-to-moderate amblyopia from anisometropic myopia, where one eye has a greater degree of myopia than the second eye.  Amblyopia, or "lazy eye," is the most common cause of unilateral visual impairment in adults.  Laser surgery is the procedure most often performed to correct adult ametropia, including mildly amblyopic eyes in the absence of organic disease. 

The study assessed the amblyopic eyes of 30 patients.  At the conclusion of their review, the authors found that in amblyopic eyes, the best spectacle-corrected visual acuity (BSCVA)

• improved >= 1 line in 16 eyes (53.3%), with a maximum improvement of 4 lines
• remained unchanged in 10 eyes (33.3%)
• decreased by 1 or 2 lines in 4 eyes (13.3%)  In the fellow nonamblyopic eyes, the best-corrected visual acuity (BCVA)
• improved by 1 or 2 lines in 9 eyes (30.3%)
• remained unchanged in 16 eyes (53.3%)
• decreased by >=1 line in 5 eyes (16.7%)

The gain of lines of BCVA was significantly greater in the amblyopic eyes group compared with the nonamblyopic eyes.  In addition, laser refractive surgery was effective and safer in amblyopic eyes to correct myopia. 

"In our series, gain in BSCVA after refractive surgery in amblyopic eyes was significantly higher than fellow nonamblyopic eyes," the authors wrote.  "We demonstrated that laser refractive surgery was safe and effective in mild-to-moderate adult amblyopic eyes."