Developmental Improvement in Children with Intellectual Disability after Photorefractive Keratectomy for Severe Isoametropia: Developmental Improvement after Pediatric PRK.

Abstract Purpose : To assess the impact of refractive error correction from photorefractive keratectomy on development in children with severe isoametropia, subnormal visual acuityk and intellectual disability unable to use refraction correction. Study Design : Prospective noncomparative interventional case series Methods : Before and after PRK, subjects who had plateaued developmentally for 18+ 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 2-8 years were included. Twelve were highly myopic (mean -9.69 ± 3.82D), three highly hyperopic (mean +5.75 ± 0.59D) and one highly astigmatic (mean +3.50D). Six months post-PRK, the DQ significantly improved for expressive communication (mean 4.51 ± 2.27 months, (p = 0.04), interpersonal relationships (mean 9.45 ± 4.18 months) (p = 0.02) and coping (mean 6.44 ± 2.10 months) (p = 0.05). Twelve months post-PRK, the DQ significantly improved for receptive communication (8.04 ± 1.80 months) (p 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.