Cedars-Sinai Medical Center Physicians Perform First Known Pediatric Laser Surgery For Farsightedness

s-Sinai for the multi-center study of laser surgery for the correction of farsightedness (hyperopia). Although the FDA's guidelines for the procedure limit its use to an adult population -- as do those of the manufacturer of the equipment, VISX Excimer Laser Systems (TM) -- both doctors thought Kiley was an excellent candidate to benefit from it.

"Dr. Wright and I discussed this case in detail to consider the risks and the benefits," said Dr. Salz. "We knew that the risks in a young person should certainly be no higher than they are in an older person. Risk of infection, for example, in a healthy young child with good tear flow is probably less than it is in a 60- or 70-year-old adult with decreased tear flow. Personal hygiene is generally going to be a little bit better, too. So we felt that in terms of serious complications -- and the only really serious one would be getting an infection -- he would not be at any higher risk than an adult. If anything, his risk would probably be lower because his resistance is probably better and his healing would probably be quicker."

Without hesitation, Kiley's parents consented to the laser's "off-label" use. "I trust Dr. Wright and whatever he says," said Linda. "And I thought, 'If the surgery works, it would be great.' Kiley's eye was so bad anyway, the risk wasn't that great to me."

Dr. Salz said that in the study of the procedure, hundreds of farsighted adults were treated and observed for about two years. No serious infections occurred. Results were similar in a Canadian study. Furthermore, nearsighted patients have benefited from laser surgery for about a decade and complications are rare.

Dr. Wright said photorefractive keratectomy is a two-step surgery that is accomplished in minutes. The eye is numbed with drops before the epithelium or outer skin of the cornea is rubbed off with a small brush. The laser is then used to reshape the curvature of the cornea. In treatment for farsightedness such as Kiley'

Contact: Sandra Van
Cedars-Sinai Medical Center

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