American Journal of Ophthalmology ( IF 4.2 ) Pub Date : 2021-08-24 , DOI: 10.1016/j.ajo.2021.08.011 Evelyn A Paysse 1 , Lingkun Kong 1 , Catherine Achim 1 , Mitchell P Weikert 1 , Bryan T Whitlow 2 , Gihan Romany 3 , David K Coats 1
PURPOSE
To assess the impact of refractive error correction from photorefractive keratectomy on development in children with severe isoametropia, subnormal visual acuity, and intellectual disability unable to use refraction correction.
DESIGN
Prospective noncomparative interventional case series.
METHODS
Before and after photorefractive keratometry (PRK), subjects who had plateaued developmentally for 18 or more months were assessed using a battery of developmental tests. The primary outcome measure was the change in the developmental quotient (DQ) 6 months after PRK. Secondary outcomes were the change in the DQ, uncorrected visual acuity, cycloplegic refraction, and corneal status 12, 24, and 36 months after PRK.
RESULTS
Sixteen subjects aged 2 to 8 years were included. Twelve were highly myopic (mean, –9.69 ± 3.82 diopters [D]), 3 highly hyperopic (mean, +5.75 ± 0.59 D) and 1 highly astigmatic (mean, +3.50 D). Six months after PRK, the DQ significantly improved for expressive communication (mean, 4.51 ± 2.27 months; P = .04), interpersonal relationships (mean, 9.45 ± 4.18 months; P = .02) and coping (mean, 6.44 ± 2.10 months; P = .05). Twelve months after PRK, the DQ significantly improved for receptive communication (8.04 ± 1.80 months; P < .001), expressive communication (6.99 ± 2.27 months; P < .05), written communication (9.28 ± 3.72 months; P < .04), domestic skills (6.50 ± 2.43 months; P < .03), interpersonal relationships (10.57 ± 4.17 months; P < .02), and coping (8.41 ± 3.25 months; P < .5).
CONCLUSIONS
PRK significantly improves developmental abilities of children with intellectual disability, severe isoametropia, and previously plateaued development, in addition to improving visual acuity and refractive error.
中文翻译:
严重等屈光性屈光角膜切除术后智力障碍儿童的发育改善
目的
评估光屈光角膜切除术矫正屈光不正对患有严重等屈光不正、视力低于正常和无法使用屈光矫正的智力障碍儿童发育的影响。
设计
前瞻性非比较介入病例系列。
方法
在屈光角膜曲率测量 (PRK) 之前和之后,使用一系列发育测试对发育稳定达 18 个月或更长时间的受试者进行评估。主要结果测量是 PRK 后 6 个月发育商 (DQ) 的变化。次要结果是 PRK 后 12、24 和 36 个月 DQ、裸眼视力、散瞳屈光度和角膜状态的变化。
结果
包括 16 名 2 至 8 岁的受试者。12 人高度近视(平均,–9.69 ± 3.82 屈光度 [D]),3 人高度远视(平均,+5.75 ± 0.59 D)和 1 人高度散光(平均,+3.50 D)。PRK 后 6 个月,DQ 在表达性沟通(平均 4.51 ± 2.27 个月;P = .04)、人际关系(平均 9.45 ± 4.18 个月;P = .02)和应对(平均 6.44 ± 2.10 个月)方面显着提高; P = .05)。PRK 后 12 个月,接受性沟通(8.04 ± 1.80 个月;P < .001)、表达性沟通(6.99 ± 2.27 个月;P < .05)、书面沟通(9.28 ± 3.72 个月;P < .04 )的 DQ 显着改善)、家庭技能(6.50 ± 2.43 个月;P < .03)、人际关系(10.57 ± 4.17 个月;P < .02)和应对(8.41 ± 3.25 个月;P < .5)。
结论
除了改善视力和屈光不正之外,PRK 还显着提高了智力残疾、严重等屈光不正和以前发育停滞的儿童的发育能力。