Comparison Of The Therapeutic Efficacy Between Overcorrecting Minus Lenses Therapy And Surgical Treatment For Small-Angle Intermittent Exotropia

Objective:Compare the surgical treatment with minus lens therapy,observe and discuss the efficacy of the two treatments for patients with small-angle intermittent exotropia.Methods:A retrospective research.48 patients with small-angle intermittent exotropia diagnosed in our hospital from October 2016 to October 2018 were collected.The patients were subjected to routine eye examination;We used prism alternate cover test to mesure the angle of deviation;The binocular vision of the patients were measured by Titmus stereogram and synoptophore;The Newcastle Control Score(NCS)was used to evaluate the control condition of patients.Follow-up at 1 month,3 months,and 6 months after treatment.Statistical analysis was performed using SPSS 17.0 statistical software.Paired t test,Chi-square test and nonparametric Wilcoxon signed rank were used to compare the efficacy of two treatment methods.Results:1.The 33cm and 6m angle of deviation were deduced after taking overcorrecting minus lenses 3 months and 6months.The difference was satistically significant(P<0.05).The 33cm and 6m angle of deviation in the surgical group were significantly lower than that before surgery(P<0.01),but there was a angle regression in the operation group.The angle of the surgical group was significantly lower than that of the overcorrecting minus lenses group at the same time(P<0.01).2.Control score:After treatment,the Newcastle scores of the two groups were significantly lower than those before treatment(P<0.05).The Newcastle score of the operation group was lower than that of the overcorrecting minus lenses group,and there was significant difference between the two groups(P<0.01).3.Binocular function:①The coincidence point of the overcorrecting minus lenses group and the surgical group were less than that before treatment(P<0.05).The coincidence point of the surgical group was significantly reduced compared with the overcorrecting minus lenses group.②The motor fusion range of the overcorrecting minus lenses group was not significantly different from that before treatment(P>0.05).The fusion range of the operation group was increased at 6 months after operation(P<0.05).There was no significant difference in the range of fusion between the two treatment groups(P>0.05).③The near-stereoscopic visual acuity of the overcorrecting minus lenses group was higher than that before treatment(P<0.05).At 3 and 6 months after treatment,the near-stereoscopic visual acuity of the operation group was higher than that before surgery(P<0.05).There was no significant difference between the treatment groups at 1 month after treatment(P=0.119),At 3 and 6 months after treatment,the visual acuity of the near-stereopsis in the surgery group was higher than that in the overcorrecting minus lenses group.(P<0.05).④In the overcorrecting minus lenses group,at 3 and 6 months after treatment,the positive rate of distant-stereopsis was higher than that before treatment(P<0.05).In the surgical treatment group,the positive rate of distant stereopsis was higher than that before treatment at each point(p<0.05).;At 1 month after treatment,the positive rate of distant-stereopsis of the surgical group was higher than that of the overcorrecting minus lenses group(P<0.05);At 3 and 6 months,there was no obvious difference between the two groups(P>0.05).Conclusion:1.Through surgical treatment,patients with small-angle intermittent exotropia can reduce the angle of deviation,promote the control of the eye position and improve the near and distant stereopsis.2.Through overcorrecting minus lenses therapy,the patients with small-angle intermittent exotropia have a slight decrease in the angle of deviation,the control power is improved,and the near and distant stereoscopic vision is improved.3.Surgical therapy is more effective than overcorrecting minus lenses therapy,but the surgery has undercorrection,overcorrection and regression.Overcorrecting minus lenses therapy can delay the operation time and even cure some patients.It is an effective non-surgical treatment.