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Lawrence Tychsen, MD

Arch Ophthalmol. 2009;127(6):810-813.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The time for refractive surgery in some children is now, not years from now. Why? Because for a few it is the only way out of blur-induced blindness, and for others, it is an effective way to augment treatment of amblyopia. I outline herein the compassionate-use, "off-label" application of refractive surgery to treat special subpopulations of ametropic children. A general strategy is explained, along with the benefits and risks associated with adapting adult techniques for use in pediatric eyes.

CHILDREN WITH BILATERAL HIGH AMETROPIA WHO ARE SPECTACLE NONCOMPLIANT BECAUSE OF A NEUROBEHAVIORAL DISORDER

These are the hard cases and the children with greatest need. Their spherical-equivalent myopia or hyperopia exceeds approximately 4 to 5 diopters (D). The uncorrected myopia translates to a distant acuity of 20/200 or worse (legal blindness). The uncorrected acuity for the child with hyperopia can be better during epochs when the child accommodates partially, but accommodation is often impaired in children with neurobehavioral disorders.¹ The prevalence of . . . [Full Text of this Article]

CHILDREN WITH ANISOMETROPIA WHO ARE SPECTACLE NONCOMPLIANT AND UNSUITED TO CONTACT LENS WEAR

CHILDREN WITH OTHER DISORDERS AND SPECIAL NEEDS THAT IMPEDE SPECTACLE WEAR

PEDIATRIC REFRACTIVE SURGERY STRATEGY AND TECHNIQUES

GAINS IN VISUAL ACUITY AND VISUAL FUNCTION

COMPLICATIONS AND CAVEATS
Advanced Surface Ablation

Phakic IOL

Clear Lens Extraction/Refractive Lens Exchange

CONCLUSIONS

AUTHOR INFORMATION
Author Affiliations: Departments of Ophthalmology and Visual Sciences, Pediatrics, Anatomy, and Neurobiology, St Louis Children's Hospital at Washington University Medical Center, St Louis, Missouri.

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