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@#AIM:To observe curative effect and safety of slanted bilateral lateral rectus recession for convergence insufficiency-type intermittent exotropia.<p>METHODS:This study included 29 patients who underwent slanted bilateral lateral rectus recession for convergence insufficiency-type intermittent exotropia in our hospital between October 2017 and November 2019 with a follow-up of 6mo, the deviation, the surgical success rate, the binocular vision function and the complications were observed.<p>RESULTS:In our study, the mean near deviations, the mean distance deviations and the near-distance deviation differences reduced from -41.72±3.35PD, -23.28±9.75PD and 16.90±2.47PD before surgery to -5.97±4.85PD, -2.66±4.78PD, 3.28±1.10PD 6mo after surgery, the surgical success rate was 76%. The Grades I and Ⅱ binocular vision function improved 6mo after surgery(<i>P</i><0.05), the distance stereopsis and the near stereopsis were not statistically significant(<i>P</i>>0.05). None of the patients developed A-V pattern, limitation of eye movement, restrictive strabismus, vertical strabismus, and rotated diplopia, some patients had transient horizontal diplopia, which disappeared within 2-3wk after surgery.<p>CONCLUSION:Slanted bilateral lateral rectus recession may successfully reduce the near exodeviations, the distance exodeviations and the near-distance deviations difference without obvious complications, proved to be a safe and effective procedure for the treatment of convergence insufficiency-type intermittent exotropia.
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@#AIM: To investigate the compliance and the relative influencing factors of orthokeratology lens in the treatment of teenagers' and children's myopia in Dongguan,and provide a scientific basic for prevention and control of myopia.<p>METHODS: Totally 757 patients of teenagers' and children's myopia with orthokeratology lens in our hospital from January 2017 to December 2017 were collected. Data from medical records and return visits by telephone, short message and Wechat were collated and summarized, then grasp the compliance and the relative influencing factors of orthokeratology lens in the treatment of teenagers' and children's myopia in Dongguan by analyzing re-examine time and persistence in wearing lens.<p>RESULTS: Totally 757 patients with mean age at 11.82±2.234 years old, including 363 males, mean aged 11.66±2.256 years old, and 394 females, mean aged 11.96±2.206 years old, there was no significant difference in age comparison of boys and girls(<i>t</i>=-1.855, <i>P</i>>0.05). In terms of re-examination compliance and persistence on wearing lens, significant difference was observed in educational stage, studying way and parents' education level(<i>P</i><0.05), no significant difference was observed in gender, area, family economic status, vision before and after wearing lens and myopia control effect(<i>P</i>>0.05). Multivariate Logistic regression analysis showed that educational stage, studying way and parents' education level were correlated with re-examination compliance and persistence on wearing lens(<i>P</i><0.05).<p>CONCLUSION: Compliance of orthokeratology lens in the treatment of teenagers' and children's myopia in Dongguan was correlated with educational stage, studying way and parents' education level, to improve the compliance of orthokeratology lens in the treatment of teenagers' and children's myopia, Standardize fitting, standardize care, normative propaganda and education, review on time and regular return visits were important.
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@#AIM: To explore the application of anterior transposition of inferior oblique muscle with unequal excision in treatment of segregated vertical strabismus with asymmetric inferior oblique hyperfunction.<p>METHODS: A total of 22 patients(10 males and 12 females, 28 eyes in all)who underwent anterior transposition of the unequal excisional inferior oblique muscle for dissociated vertical deviation with asymmetric inferior oblique muscle overaction were studied retrospectively. The patients were admitted from June 2015 to June 2017,with mean age at 12.32±6.81 years old(ranging from 3 to 28 years old). The binocular vision, the curative effect of DVD, the curative effect of inferior oblique muscle overaction, eye position and compensatory head posture, complications were examined postoperatively, follow-up survey was conducted at 6 to 18mo, meanly at 10.05±3.87mo.<p>RESULTS: Recovery of binocular vision: 11 cases did not have binocular vision(50%); 6 cases recovered to the first level of binocular vision(27%); 3 cases recovered to the second level of binocular vision(14%); 2 cases recovered to the third level of binocular vision(9%). The curative effect of DVD shows: 17 cases with satisfaction(77%), 5 cases with improvement(23%), and 0 case with no avail. The curative effect of inferior oblique muscle overaction shows: 13 cases with cured(59%), 9 cases with improvement(41%), and 0 case with no avail. Postoperative eye position and compensatory head posture: 1)Horizontal eye position: 1 case of under correction after exotropia correction surgery, 1 case of under correction after esotropia correction surgery, 0 case of overcorrection, 20 cases of correction; 2)Vertical eye position: 13 cases show vertical strabism deviation less than 5△, 9 cases show vertical strabism deviation between 5△ to 10△ meanly at 5.55△±2.35△, vertical eye position without overcorrection; 3)Compensatory head posture: 6 cases were disappeared, 1 case was improved. Complications: Mild anti-elevation syndromeoccurred in 1 case, narrowed palpebral fissueoccurred in 1 case, and narrowed quantity less than 1mm.<p>CONCLUSION: In general, the curative effect of anterior transposition of the unequal excisional inferior oblique muscle for dissociated vertical deviation with asymmetric inferior oblique muscle overactionis satisfactory, standard preoperative examination, individualized surgical design and surgical techniques are necessary.