Archive | 2021
Surgical versus optical treatment for anisometropia in adults: a randomized controlled trial
Abstract
Background: To assess, evaluate, and compare outcomes of laser-assisted in situ keratomileusis (LASIK) versus optical spectacles correction in the treatment of anisometropia in adult patients we aimed to perform this study. \nMethods: This prospective randomized controlled clinical trial included 50 eyes of 50 patients. We randomly distributed the participants into two groups comprise group A (experimental/LASIK group) consist of 25 eyes with anisometropia and assigned for LASIK treatment, as well as group B (control/spectacles group), consist of 25 eyes with anisometropia and allocated for optical spectacles correction. All patients underwent preoperative and postoperative visual acuity, subjective and cycloplegic refraction, fundus, slit-lamp, and corneal topography examinations. \nResults: In group A, at one month postoperation, there were statistically significant differences in uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refractive sphere, cylinder and spherical equivalent (SE). Three month postoperation, SE showed good stability within ±0.50 diopter (D) in 22 eyes (88%) and within ± 0.75D in 23 eyes (92%), while two eyes had an SE beyond 1.00D of emmetropia in group A. Five eyes revealed amblyopia with minimal improvement in two eyes in group A following LASIK and no improvement in three eyes treated with spectacles in group B. Two amblyopic eyes had developed ocular deviations at the end of the study that referred to the strabismus unit. \nConclusions: Our outcomes revealed that LASIK was more effective and more advantageous than spectacles in the treatment of different types of anisometropia in adults. However, future randomized trials with a focus on optical versus surgical treatment of anisometropia and anisometropic amblyopia in both pediatric and adult patients are needed to further confirm the conclusions of this study and enhance our confidence for generalizing this modality of treatment.