Pencil push-up training compared with binocular vision training in the management of slight post-operative under-correction of intermittent exotropia: A prospective study.
Humans
Exotropia
/ surgery
Prospective Studies
Vision, Binocular
/ physiology
Female
Male
Visual Acuity
/ physiology
Ophthalmologic Surgical Procedures
/ methods
Child
Oculomotor Muscles
/ surgery
Child, Preschool
Follow-Up Studies
Treatment Outcome
Postoperative Period
Depth Perception
/ physiology
Journal
Indian journal of ophthalmology
ISSN: 1998-3689
Titre abrégé: Indian J Ophthalmol
Pays: India
ID NLM: 0405376
Informations de publication
Date de publication:
01 Aug 2024
01 Aug 2024
Historique:
received:
10
11
2023
accepted:
03
04
2024
medline:
30
7
2024
pubmed:
30
7
2024
entrez:
30
7
2024
Statut:
ppublish
Résumé
This study aims to compare the effectiveness of pencil push-up training and binocular vision training in treating post-operative mild under-correction in patients with intermittent exotropia. A prospective cohort study was conducted, including patients who underwent surgery for intermittent exotropia at Children's Hospital of Nanjing Medical University between June 2022 and January 2023 and experienced post-operative mild under-correction (-8∆ to -15∆). Patients were divided into two groups: pencil push-up training group and binocular vision training group. All patients underwent measurements of exodeviation and stereoacuity at distance and near, sensory fusion, and fusion convergence amplitude. The data were analyzed using independent sample t-tests, repeated measures analysis of variance, and Chi-square tests. There were no statistically significant differences in exodeviation at distance and near between the two training groups before the training. After 6 months of training, the exodeviation at distance and near achieved a significant decrease in both groups (P < 0.05), and the pencil push-up training group showed a similar distance and near exodeviation compared to the binocular vision training group (t = 1.58, P ＞ 0.05; t = 0.43, P ＞ 0.05). After 6 months of training, the binocular vision training group exhibited significantly superior stereoacuity and fusion convergence amplitude compared to the pencil push-up training group (P < 0.001). Both pencil push-up training and binocular vision training are effective in reducing exodeviation in patients with post-operative mild under-correction of intermittent exotropia. However, binocular vision training demonstrates superior efficacy in restoring stereopsis and fusion convergence amplitude compared to pencil push-up training.
Identifiants
pubmed: 39078966
doi: 10.4103/IJO.IJO_2979_23
pii: 02223307-202472080-00023
doi:
Types de publication
Journal Article
Comparative Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1204-1209Informations de copyright
Copyright © 2024 Copyright: © 2024 Indian Journal of Ophthalmology.
Références
Ekdawi NS, Nusz KJ, Diehl NN, Mohney BG. Postoperative outcomes in children with intermittent exotropia from a population-based cohort. J AAPOS 2009;13:4–7.
Wang Z, Li T, Zuo X, Liu L, Zhang T, Leng Z, et al. Preoperative and postoperative clinical factors in predicting the early recurrence risk of intermittent exotropia after surgery. Am J Ophthalmol 2023;251:115–25.
Repka MX, Chandler DL, Holmes JM, Donahue SP, Hoover DL, Mohney BG, et al. The relationship of age and other baseline factors to outcome of initial surgery for intermittent exotropia. Am J Ophthalmol 2020;212:153–61.
Kim DH, Yang HK, Hwang JM. Long term surgical outcomes of unilateral recession-resection versus bilateral lateral rectus recession in basic-type intermittent exotropia in children. Sci Rep 2021;11:19383.
Xie F, Zhao K, Zhang W. Comparison of surgical outcomes between bilateral recession and unilateral recession-resection in moderate-angle intermittent exotropia. J AAPOS 2019;23:79 e1-7.
Wang L, Wu Q, Kong X, Li Z. Comparison of bilateral lateral rectus recession and unilateral recession resection for basic type intermittent exotropia in children. Br J Ophthalmol 2013;97:870–3.
Ma MM, Kang Y, Scheiman M, Chen X. Office-based vergence and accommodative therapy for the treatment of intermittent exotropia: A pilot study. Optom Vis Sci 2019;96:925–33.
Xu M, Peng Y, Zheng F, Yu H, Zhou J, Zheng J, et al. The effects of orthoptic therapy on the surgical outcome in children with intermittent exotropia: Randomised controlled clinical trial. J Clin Med 2023;12:1283.
Hatt SR, Leske DA, Mohney BG, Brodsky MC, Holmes JM. Fusional convergence in childhood intermittent exotropia. Am J Ophthalmol 2011;152:314–9.
Convergence Insufficiency Treatment Trial Study Group. Randomized clinical trial of treatments for symptomatic convergence insufficiency in children. Arch Ophthalmol 2008;126:1336–49.
Chia A, Seenyen L, Long QB. Surgical experiences with two-muscle surgery for the treatment of intermittent exotropia. J AAPOS 2006;10:206–11.
Figueira EC, Hing S. Intermittent exotropia: Comparison of treatments. Clin Exp Ophthalmol 2006;34:245–51.
Lee HJ, Kim SJ. Longitudinal course of consecutive esotropia in children following surgery for basic-type intermittent exotropia. Eye (Lond) 2022;36:102–10.
Maruo T, Kubota N, Sakaue T, Usui C. Intermittent exotropia surgery in children: Long term outcome regarding changes in binocular alignment. A study of 666 cases. Binocul Vis Strabismus Q 2001;16:265–70.
Pediatric Eye Disease Investigator Group; Cotter SA, Mohney BG, Chandler DL, Holmes JM, Repka MX, et al. A randomized trial comparing part-time patching with observation for children 3 to 10 years of age with intermittent exotropia. Ophthalmology 2014;121:2299–310.
Patwardhan SD, Sharma P, Saxena R, Khanduja SK. Preferred clinical practice in convergence insufficiency in India: A survey. Indian J Ophthalmol 2008;56:303–6.