Cho Yoonae A, Ryu Won Yeol
Nune Eye Hospital, Seoul, Republic of Korea Strabismus Center of Ophthalmology, Korea University College of Medicine, Seoul, Republic of Korea.
Department of Ophthalmology, Dong-A University College of Medicine, Busan, Republic of Korea.
Br J Ophthalmol. 2015 May;99(5):680-4. doi: 10.1136/bjophthalmol-2014-305991. Epub 2014 Nov 21.
To determine the long-term changes in refractive error and ocular alignment in patients with accommodative esotropia (AET) who were able to discontinue wearing hyperopic glasses because of emmetropisation.
Forty-seven patients with refractive AET who achieved emmetropisation and orthotropia without hyperopic glasses and were followed up for at least 3 years were enrolled. All of the patients had been prescribed the weakest possible glasses for best corrected vision. Refractive error and ocular alignment were analysed after the cessation of hyperopic glasses use.
The mean length of follow-up was 5.7±3.21 years after successful weaning from hyperoptic glasses. The mean spherical equivalent (SE) of the refractive error was -1.01±1.53 dioptres (D), and the mean esotropia (ET) was 1.0±8.70 Δ at the final visit. Myopia developed in 55.3% of all patients. The mean myopic progression rate per year was -0.19±0.23 D/year. Forty-one patients (87.2%) showed orthotropia; in addition, three of the patients (6.4%) developed ET, and three (6.4%) developed exotropia (XT). The six patients who had ET or XT all showed myopia. Two of the three patients who developed ET underwent surgery. Both patients initially had a low degree of hyperopia and a high ratio of accommodative convergence to accommodation (AC/A). The initial hyperopia correlated with the SE refractive error at the final follow-up (p<0.001).
When emmetropisation occurs early in patients with AET, it is necessary to note the development of myopia and the deterioration of ocular alignment.
确定因正视化而能够停止佩戴远视眼镜的调节性内斜视（AET）患者屈光不正和眼位的长期变化。
纳入47例屈光性AET患者，这些患者在未佩戴远视眼镜的情况下实现了正视化和正位，并随访至少3年。所有患者均被开具能获得最佳矫正视力的最弱度数眼镜。在停止使用远视眼镜后分析屈光不正和眼位。
成功停用远视眼镜后平均随访时间为5.7±3.21年。末次随访时屈光不正的平均等效球镜度（SE）为-1.01±1.53屈光度（D），平均内斜视（ET）为1.0±8.70棱镜度（Δ）。所有患者中有55.3%出现近视。每年平均近视进展率为-0.19±0.23 D/年。41例患者（87.2%）表现为正位；此外，3例患者（6.4%）发生内斜视，3例（6.4%）发生外斜视（XT）。发生内斜视或外斜视的6例患者均表现为近视。发生内斜视的3例患者中有2例接受了手术。这2例患者最初远视度数低且调节性集合与调节的比率（AC/A）高。初始远视与末次随访时的SE屈光不正相关（p<0.001）。
当AET患者早期发生正视化时，有必要注意近视的发展和眼位的恶化。
