- Journal of Pediatric Ophthalmology and Strabismus
- September/October 2011 - Volume 48 · Issue 5: 278-284
To evaluate changes in the angle of deviation after spectacle correction in patients who had hyperopia and intermittent exotropia (X(T)) and to determine whether the changes and surgical outcomes differ when compared with those of myopic and emmetropic X(T).
One hundred fourteen patients with X(T) were recruited and allocated into three groups: X(T) with hyperopia (group I; 38 patients), X(T) with emmetropia (group II; 35 patients), and X(T) with myopia (group III; 41 patients). After at least 6 months wearing spectacles, changes in exodeviation were compared. The results of surgery based on the spectacle-corrected distance angle and the ratios of accommodative convergence over accommodation (AC/A) were also assessed.
With spectacle correction, the mean exodeviation increased significantly in group I, but did not change in groups II or III. Thirteen patients in group I (34%) showed a more than 10 prism diopters (PD) exotropic shift after wearing spectacles. The mean AC/A ratio in group I was 2.63 (PD/D), whereas in groups II and III the ratios were 4.03 and 4.06, respectively. There was no difference in surgical results among the three groups.
Although hyperopic correction in patients with X(T) resulted in a limited increase in exodeviation with a subnormal AC/A ratio, one-third of the patients experienced a significant increase in exodeviation. A spectacle correction trial should be considered before surgery in patients with hyperopia and X(T).
From the Department of Ophthalmology (SAC), Ajou University School of Medicine, Suwon; and the Institute of Vision Research (ISK, WKK, JBL), Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.
Presented as a poster at the 32nd Meeting of the European Strabismological Association, September 7–10, 2008, Munich, Germany.
The authors have no financial or proprietary interest in the materials presented herein.
Address correspondence to Jong Bok Lee, MD, Department of Ophthalmology, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul 120-752, Korea. E-mail: email@example.com
Received: March 10, 2010
Accepted: November 16, 2010
Posted Online: December 22, 2010