Department of Ophthalmology, Tianjin Medical University General Hospital, No. 154, Anshan Road, Tianjin, 300052, China.
Department of Strabismus and Pediatric Ophthalmology, Shanxi Eye Hospital, Taiyuan, 030002, Shanxi, China.
BMC Ophthalmol. 2022 Jun 24;22(1):276. doi: 10.1186/s12886-022-02501-z.
This study aimed to assess the efficacy of prismatic treatment in a step-by-step manner to reduce prismatic strength in acute acquired concomitant esotropia (AACE) of 25 prism diopters (PD) or less.
In this retrospective comparative study, 36 patients with AACE with deviation angle ≤ 25 PD were treated with Fresnel prism in a step-by-step manner to reduce prismatic strength. The patients were divided into two groups according to whether they regained orthophoria and were weaned off the press-on prisms within 1 year: (1) the treatment-success group, which consisted of patients who had their esotropia eliminated and were weaned off the press-on prisms within 1 year after prism correction, and (2) the treatment-continuing group, which comprised patients who needed to continue wearing a Fresnel prism at 1 year after the beginning of prismatic correction because diplopia and esotropia still existed. Clinical characteristics and cooperation were analyzed and compared between groups.
Fourteen of 36 patients (38.9%) were weaned off the prism and regained orthophoria and binocular single vision within 1 year after prismatic treatment. Compared with the treatment-continuing group, the treatment-success group showed smaller deviation at near and distant fixations (P = 0.024 and P = 0.006, respectively) measured at the beginning of prismatic correction, a shorter time from onset to prismatic treatment (P = 0.02), and a greater percentage of patients exhibiting good cooperation (P < 0.001).
Prismatic treatment in a step-by-step manner to reduce prismatic strength can lead to good outcomes of motor alignment and binocular function in patients with AACE of 25 PD or less. Patients showing good cooperation, smaller angle of esotropia, and shorter duration from onset to treatment tend to eliminate esotropia and be weaned off press-on prisms within 1 year after prismatic correction.
本研究旨在评估逐步减少棱镜强度对 25 棱镜度（PD）或以下急性获得性共同性内斜视（AACE）的疗效。
在这项回顾性对比研究中，36 例 AACE 患者采用 Fresnel 棱镜进行逐步治疗以降低棱镜强度，斜视角度≤25PD。根据是否在 1 年内恢复正位并停止使用压贴棱镜，将患者分为两组：（1）治疗成功组，包括斜视消除且在棱镜矫正后 1 年内停止使用压贴棱镜的患者；（2）治疗持续组，包括在棱镜矫正开始后 1 年内仍需要继续佩戴 Fresnel 棱镜的患者。分析并比较两组患者的临床特征和配合情况。
36 例患者中有 14 例（38.9%）在棱镜治疗后 1 年内停止使用棱镜并恢复正位和双眼单视。与治疗持续组相比，治疗成功组在棱镜矫正开始时的近距和远距斜视度更小（P=0.024 和 P=0.006），从发病到棱镜治疗的时间更短（P=0.02），并且具有更好合作的患者比例更高（P<0.001）。
逐步减少棱镜强度的棱镜治疗可使 25PD 或以下 AACE 患者获得良好的运动对准和双眼功能结果。具有良好合作、较小斜视角度和发病到治疗时间较短的患者往往能够在棱镜矫正后 1 年内消除斜视并停止使用压贴棱镜。
