Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43 Gil, Songpa-gu, Seoul, 05505, South Korea.
Graefes Arch Clin Exp Ophthalmol. 2020 Jun;258(6):1327-1333. doi: 10.1007/s00417-020-04700-0. Epub 2020 Apr 19.
To investigate the difference in the rate of myopia progression between the dominant and non-dominant eye in patients with intermittent exotropia (IXT).
We retrospectively reviewed the medical records of 33 patients who underwent surgery and later reoperation for IXT. We included only patients whose spherical equivalent refractive errors (SER) were ≤ - 0.50 diopter (D) in at least one eye at the time of reoperation. The main outcome measurement was the rate of myopia progression, which was defined as the mean annual change in SER between the first and second surgery. We classified patients into two groups: group A, which comprised 25 patients whose non-dominant eyes showed a faster myopia progression than their dominant eyes, and group B, which comprised the remaining 8 patients showing the opposite.
Mean age of the patients at the time of the initial surgery was 5.64 years. Mean interval between the initial and second surgery was 4.45 years. Mean rate of myopia progression over the interval was - 0.37 D/year in the dominant eyes and - 0.50 D/year in the non-dominant eyes (P < 0.001). Group A had a significantly greater amount of distance deviation (31.0 vs. 25.6 PD, P = 0.020) and near deviation (30.8 vs 26.0 PD, P = 0.039) before the initial surgery and a significantly worse score of distance control (3.05 vs. 2.00, P = 0.023) before the second surgery than group B.
The non-dominant eyes experienced a faster myopia progression than the dominant eyes in patients with IXT. This faster myopia progression demonstrated in the non-dominant eyes was associated with clinically severe exotropia in terms of the amount of deviation and the degree of control.
探讨间歇性外斜视（IXT）患者主眼和非主眼近视进展率的差异。
我们回顾性分析了 33 例因 IXT 接受手术和再次手术的患者的病历。仅纳入在再次手术时至少一眼的等效球镜（SER）≤ - 0.50 屈光度（D）的患者。主要观察指标为近视进展率，定义为第一次手术和第二次手术之间 SER 的平均年变化。我们将患者分为两组：A 组，25 例患者的非主眼近视进展速度快于主眼；B 组，其余 8 例患者的主眼近视进展速度快于非主眼。
初次手术时患者的平均年龄为 5.64 岁。初次手术和再次手术之间的平均间隔时间为 4.45 年。间隔期间近视进展的平均速度在主眼为- 0.37 D/年，在非主眼为- 0.50 D/年（P < 0.001）。初次手术前，A 组的距离偏斜量（31.0 与 25.6 PD，P = 0.020）和近距偏斜量（30.8 与 26.0 PD，P = 0.039）明显大于 B 组，而二次手术前的距离控制力评分（3.05 与 2.00，P = 0.023）明显低于 B 组。
在 IXT 患者中，非主眼的近视进展速度快于主眼。非主眼的这种更快的近视进展与偏斜量和控制力的严重程度有关。
