Related Experiment Video
Updated: Aug 30, 2026
Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis
Published on: November 12, 2015
Successful implementation of a protocol for photorefractive keratectomy in children requiring anesthesia
Evelyn A Paysse1, Mohamed A W Hussein, Douglas D Koch
1Cullen Eye Institute, Department of Ophthalmology, Texas Children's Hospital, Houston, Texas 77030, USA. epaysse@bcm.tmc.edu
Insights
This study details a safe protocol for pediatric photorefractive keratectomy (PRK) under general anesthesia, showing no complications. The method is effective for children unable to cooperate with local anesthesia.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Anesthesiology
Background:
- Pediatric refractive errors like anisometropia, high myopia, or high hyperopia can lead to amblyopia.
- Photorefractive keratectomy (PRK) is an effective refractive surgery, but cooperation is challenging in young children.
- General anesthesia offers a solution for performing PRK in uncooperative pediatric patients.
Purpose of the Study:
- To outline a protocol for pediatric photorefractive keratectomy (PRK) under general anesthesia.
- To evaluate intraoperative and postoperative complications associated with this procedure.
- To assess the efficacy and safety of PRK in young children requiring refractive correction.
Main Methods:
- A protocol was developed for PRK in nine pediatric patients (ages 3-9) with unilateral high myopia/hyperopia and amblyopia.
- Procedures were conducted under general anesthesia, with separate induction and surgical rooms.
- Precautions were taken to manage anesthetic agents and ensure precise laser application, monitoring eye position throughout.
Main Results:
- All nine pediatric patients tolerated the PRK procedure well.
- No anesthesia-related complications were reported.
- No treatment-related complications occurred during or after the PRK surgery.
Conclusions:
- The described protocol for PRK under general anesthesia is effective and efficient for pediatric patients.
- This approach is suitable for children unable to cooperate with local anesthesia-based procedures.
- The protocol can be adapted for other refractive surgeries, including laser in situ keratomileusis (LASIK), in children and uncooperative adults.
Purpose:
To describe a protocol for treating children with photorefractive keratectomy (PRK) under general anesthesia and to review intraoperative and postoperative complications.
Setting:
Institutional academic practice.
Methods:
Nine patients between 3 years and 9 years of age were treated with PRK under general anesthesia for anisometropia with unilateral high myopia or high hyperopia and amblyopia of the affected eye. Induction of anesthesia and the surgical procedure were carried out in separate rooms. The laser beam was centered on the entrance pupil, and eye position was monitored throughout the procedure. Specific precautions were taken before and during the procedure to prevent unwanted effects of inhalational anesthetic agents on laser performance.
Results:
All children did well, with no anesthesia-related or treatment-related complications.
Conclusions:
Our protocol for PRK under general anesthesia was effective and efficient in children who were unable to cooperate for the procedure using local anesthesia. It can be adapted for laser in situ keratomileusis and other refractive surgical procedures in children and uncooperative adults.
