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Automatic Lamellar Keratoplasty Miopic Anisometropia

Usov V.,
The Filatov Institute of Eye Diseases, Department of corneal microsurgery (Odessa)

Purpose: Anisometropia is a frequent cause of visual disorders. The incidence of high myopic anisometropia is encountered in 50-60%. Recent years have been marked by a continuous search for efficient ophthalmic techniques to surgically correct myopic anisometropia.
Methods: This study evaluates the outcome of surgical correction of myopic anisometropia by using an original method of automated lamellar keratoplasty with help of a microkeratome - Chiron automated corneal shaper. The procedure was performed on 66 eyes of 43 patients with myopia between -5.0D and -22.0D (mean preoperative spherical equivalent -12.0±3.76D). In the I group 20 patients (20 eyes) was operated only “worse” eyes with mean preoperative spherical equivalent -10.4±2.9D. The initially level of anisometropia was at mean 9.65±3.06D. In the II group 23 patients (46 eyes) was operated both eyes with mean preoperative spherical equivalent -14.5±3.8D). The initially level of anisometropia in the II group was at mean 6.5±2.5. The type of vision in 18 (41.8%) patients preoperatively was unstable binocular within 1 meter from color test, farther it was simultaneous. All had stable refraction for at least one year and could not be comfortably corrected with glasses or contact lenses.
Results: Low uncorrected preoperative visual acuity (0.04±0.03) increased to 0.7±0.23 postoperatively in both operations group. Obtained clinical refraction amounted at -0.96±0.55D in the I group and -1.72±0.78D in the II group. The difference between both eyes refraction decreased to 0.72±0.48D in the I group and 0.67±0.52D in the II group. After operation was restored binocular binocular vision in 81.4%.
Conclusions: The clinical results obtained and the absence of severe complications to recommend the automated lamellar keratoplasty with Chiron automated corneal shaper us an effective method of surgical correction of myopic anisometropia and provide normal binocular function.