Early Clinical Observation On The Convergence Insurfficiency-type Intermittent Exotropia With Two Different Operative Methods

Objective:To compare the early effects of two different surgical treatments for intermittent exotropia with convergence insufficient.Methods:Using the methods of restrospective research.Collected 35 patients(51 eyes)with complete clinical data who were diagnosed as intermittent exotropia with convergence insurfficiency in our hospital from December 2015 to February 2017were divided into groups A and B according to the operation type.Group A 15 cases(15eyes),the lateral rectus recession combined with medial rectus resction and group B 20 cases(36 eyes),slanted lateral rectus recession.The normotopia rate and the improvement rate of near stereoscopic vision were compared with 12 months follow-up date.Results:1.There was no significant difference in sex(?2=0.772,P=0.38)and age(?2=4.375,P=0.993)between the two groups before operation.2.Comparison of postoperatively normotopia rate:Group A 15 cases before operation,8 cases were straightened out to primary position by followed up 12 months after operation,the normotopia rate was 53.33%;There were 20 patients in group B befre operaton,17cases were straightened out to primary position by followed up 1 year after operation,the normotopia rate was 85%.By Peareson chi-square test,the normotopia rate in group B was significantly higher than that in group A(?~2=4.212,P=0.04),the difference was statistically significant.3.Comparison of postoperatively near stereoscopic function improvement rate:There was no significant difference between the two groups of patients with near stereoscopic vision before operation(?~2=0.527,P=0.602).In group A,there were 4 patients with normal near stereoacuity,6 cases were lower than standard and 5 cases had no near stereoacuity before operation;there were 7 patients with normal near stereoacuity,5 cases were lower than standard and 3cases had no near stereoacuity after operation,the total improvement rate was 33.33%;In group B,there were 1 patients with normal near stereoacuity,14 cases were lower than standard and 5 cases had no near stereoacuity before operation;there were 12patients with normal near stereoacuity,6 cases were lower than standard and 2 cases had no near stereoacuity after operation,the total improvement rate was 70%;By Peareson chi-square test,the improvement rate of near stereoscopic vision function in group B was significantly higher than that in group A(?~2=4.644,P=0.031),the difference was statistically significant.Conclusions:The slanted latera rectus recession were superior to the surgery of the lateral rectus recession combined with medial rectus resction for the early postoperative normotopia rate and the improvement rate of near stereoscopic function in the treatment of intermittent exotropia with convergence insurfficiency.