American Association of Hip and Knee Surgeons Annual Meeting
American Association of Hip and Knee Surgeons Annual Meeting
Perspective from M. Edward Wilson, MD
May 21, 2015
1 min read

Long-term development improves after PRK in children with neurobehavioral disorders and isoametropic amblyopia

Perspective from M. Edward Wilson, MD
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NEWPORT, R.I. — PRK in children with neurobehavioral disorders and severe isoametropia not only improves visual acuity but also improves communication skills, activities of daily living and socialization, according to a speaker.

In these children with severe refractive error that goes uncorrected because of an inability to wear spectacles, varying levels of visual impairment may result, not unlike form vision deprivation seen with dense cataract, Evelyn A. Paysse, MD, said at the American Ophthalmological Society meeting.

Evelyn A. Paysse

“Just like other sorts of problems in children that used to be thought of as crazy to do, like pediatric cataract, there is something surgical that can be done that normalizes refractive error. ... Think about this type of amblyopia in a different way than your garden-variety amblyopia,” she said. “These children, if they go uncorrected, will have permanent visual impairments.”

Paysse reported a prospective, interventional case series of 15 children aged 4 to 11 years with neurobehavioral disorders, noncompliance with refractive correction and very high refractive error to assess the long-term impact of PRK on behavior.

The primary outcome at 6 months and 36 months postoperatively was change in developmental quotient (DQ) in the subdomains of development, including communication, daily living skills, socialization, motor skills and adaptive skills. Although improvement was seen in all domains, statistically significant improvement was seen in communication, daily living skills and socialization. All subdomain DQs plateaued at 36 months, which implies improvement, Paysse said.

“If the DQ stays the same over time, that means there is some increase in the mental age as well as the biologic age,” she said.

Paysse said there was “excellent response” to the secondary outcomes, which were ophthalmological: changes in uncorrected visual acuity, best corrected visual acuity, cycloplegic refraction and corneal status.

“In essence, parents are overjoyed. This changes their life,” she said. - by Patricia Nale, ELS

Disclosure: Paysse reports no relevant financial disclosures.