Paula Jayter Silva de, Ibrahim Fuad Moraes, Martins Marcia Clivati, Bicas Harley Edison Amaral, Velasco e Cruz Antonio Augusto
Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo - USP, Ribeirão Preto, SP, Brazil.
Arq Bras Oftalmol. 2009 Nov-Dec;72(6):751-4. doi: 10.1590/s0004-27492009000600002.
Intermittent exotropia may be decreased by stimulation of accommodative convergence. Once excessive accommodation has been related to myopia, our objective was to evaluate refractive errors changes in children under overcorrecting minus lens therapy.
A retrospective chart review of 21 children with intermittent exotropia was performed. All patients were treated with occlusion, and a 13-patient subset of them received overminus lens therapy (group A). Eight children received spectacles as necessary (group B). Initial age, age interval, initial spherical equivalent (SE), and magnitude of overcorrection were considered as co-variables of the mean variation in refractive error (SE of each eye) between groups, through a multivariate analysis.
Overcorrection used in group A ranged from 0.5 D to 3.5 D (2.46 +/- 0.87 D). Although initial SE of each eye was significant different between group A and B (OD - p=0.02; OS - p=0.01), initial age (p=0.69), age interval (p=0.90), and mean variation in refractive errors (p=0.36) did not differ between groups. Multivariate analysis with linear regression showed no significantly difference regarding all co-variables enrolled.
Treatment of intermittent exotropia with overcorrecting minus lens did not induce refractive errors changes, even considering age, treatment period, initial spherical equivalent and overcorrection magnitude used.
通过刺激调节性集合可减少间歇性外斜视。一旦过度调节与近视相关,我们的目的是评估在过矫负透镜治疗下儿童屈光不正的变化。
对21例间歇性外斜视患儿进行回顾性病历审查。所有患者均接受遮盖治疗,其中13例患者接受过矫负透镜治疗(A组)。8例儿童必要时佩戴眼镜(B组)。通过多变量分析,将初始年龄、年龄间隔、初始等效球镜度(SE)和过矫量视为两组间屈光不正平均变化(每只眼睛的SE)的协变量。
A组使用的过矫量范围为0.5 D至3.5 D(2.46±0.87 D)。虽然A组和B组每只眼睛的初始SE有显著差异(右眼 - p = 0.02;左眼 - p = 0.01),但两组间的初始年龄(p = 0.69)、年龄间隔(p = 0.90)和屈光不正平均变化(p = 0.36)无差异。线性回归多变量分析显示,纳入的所有协变量均无显著差异。
即使考虑年龄、治疗时间、初始等效球镜度和使用的过矫量,用过矫负透镜治疗间歇性外斜视也不会引起屈光不正的变化。