| Purpose To investigate the influence of surgery on myopia progression and corneal morphology in children aged from 4 to 12 with basic type of intermittent exotropia(IXT).Methods 270 children(from 4 years to 12 years of age)who visited the pediatric clinics of the Second Affiliated Hospital of Da Lian Medical University from 2016 to 2017 were included in this study.We divided all the individuals into three groups.In the study group,we selected patients aged from 4 to 12 with basic type of IXT who had underwent surgery in our center.In contrast,the control cohort include patients with basic type of IXT who hadn't underwent sugery(the observation group)and myopic children without IXT(the control group),the spherical equivalent refraction was no more than-2.0 D in the control group.Besides,90 patients in each group were divided into three groups according to their ages,the age groups included 4-7 years old group,7-9 years old group,9-12 years old group.The type of surgery of the study group was bilateral lateral rectus recession,all the surgeries were operated by the same senior ophthalmologist.The time for follow were at 1,3,6 and 12 postoperative month.The initial and subsequent refractions were determined through the topical administration of1% atropine.The diopter was measured by computer optometry and retinoscopy optometry.The corneal curvature,the rates of the asphericity(Q value)of the anterior cornea,the surface regularity index(SRI),the surface asymmetry index(SAI)and other optical information were all obtained by the OPD—SCAN—? aberrometer.The clinical data from different groups were compared and statistically analysed.Variables were compared by Chi2 test,T-test and Multiple-factor repetitive measurement and analysis.Results The average age for surgery was 108.3 months on the study group.The initial refrections were-0.74±1.18 D in Group A,0.67±1.17 D in Group B and-0.80±0.60 D in Group C,there were no significant differences among three groups(P>0.05).The preoperative and the postoperative rates of myopic progression were-1.50±0.11 dioptre(D)/year and-0.91±0.26 D/year in study group,they were significantly different(P<0.05).The rates of myopic progression were-0.91±0.26 D/year in postoperative study group,-1.52±0.08 D/year in observation group and-0.88±0.05 D/year in control group,the variations of the refractions were significantly different among three groups(P<0.05),the rate of myopia progression in observation group was higher than the study group and the control group,and there were no significant differences between the study group and the control group.The outline drawings of SRI and SAI showed a significant upward trend at a postoperative month and they declined whereafter in the study group.There were no significant intergroup differences in the rates of the asphericity(Q value)of the anterior cornea among three groups.Conclusions The findings from this study of 270 chinese children with fundamental form of IXT aged from 4 to 12 showed a significant trend toward myopia over time and BLR for IXT can effectively respite the development of myopia.SRI and SAI increase apparently at the first month after surgery for IXT.However,they have no statistically significant difference at one postoperative year compared to the preoperative situation.Basically,surgery for IXT just aroused transient transformation of the corneal morphology.So we reach the conclusion that surgery for patients aged from 4 to 12 with basic type of IXT could effectively respite the development of myopia and surgery for IXT aroused transient transformation of the corneal morphology. |
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