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AIM: To investigate the status of stereoscopic reconstruction in adults with intermittent exotropia after surgery, and analyze related influencing factors.METHODS: A retrospective study was conducted among 196 adults with intermittent exotropia who were admitted to our hospital from January 2019 to January 2021. All patients underwent strabismus surgery, and their preoperative and postoperative data were collected.RESULTS: Near and distal stereo visual function was not found in all the included 196 patients before surgery. The reconstruction rates of near stereo visual function and distal stereo visual function were 52.6%(103/196)and 50.5%(99/196), respectively. There were significant differences in surgical age, age of onset, course of disease, and postoperative level of horizontal strabismus between patients with near stereoscopic reconstruction(103 cases)and those without reconstruction(93 cases; P<0.001). Multivariate Logistic regression analysis showed that age of onset, course of disease, and postoperative level of horizontal strabismus were factors influencing near stereo visual function reconstruction(P<0.05). The receiver operating characteristic(ROC)curve showed that the area under the curve(AUC)values of age of onset, course of disease and postoperative level of horizontal strabismus to predict near stereo visual function reconstruction were 0.757, 0.737 and 0.727, respectively(P<0.001). There were significant differences in surgical age, age of onset, course of disease, and postoperative level of horizontal strabismus between patients with distal stereoscopic reconstruction(99 cases)and those without reconstruction(97 cases; P<0.001). Multivariate Logistic regression analysis showed that age of onset and course of disease were factors influencing distal stereo visual function reconstruction(P<0.05). ROC curve showed that the AUC values of age of onset and course of disease to predict distal stereo visual function reconstruction were 0.672 and 0.821, respectively(P<0.001).CONCLUSION: Stereoscopic reconstruction in adults with intermittent exotropia after surgery is affected by many factors, such as age of onset and course of disease. The influencing factors of near stereo visual function reconstruction and distal stereo visual function reconstruction are different, which deserves attention.
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AIM: To investigate the differences in squint angle measured by right angle prism and isosceles angle prism.METHODS: Case control study. A total of 176 cases of concomitant strabismus admitted to our hospital from June 2021 to April 2022 were selected, among which 79 cases were concomitant esotropia and 97 cases were concomitant exotropia. The squint angle of all patients was measured respectively by alternating cover right angle prism and isosceles angle prism.RESULT: For patients with concomitant esotropia, the right angle prism degree was 49.167△±13.573△ and the isosceles angle prism degree was 38.250△±10.756△ (P<0.01), with a difference of 10.917△±3.752△; the measurement of right angle prism converted to circular degree was 19.096°±2.456°, and the isosceles angle prism value was 20.847°±5.364°(P<0.05), with a difference of 2.443°±2.702°. For patients with concomitant exotropia, the right angle prism degree was 51.875△±13.567△, and the isosceles angle prism degree was 40.492△±11.753△ (P<0.01), with a difference of 11.383△±4.783△; the measurement of right angle prism converted to circular degree was 19.589°±2.521°, and the isosceles angle prism value was 21.947°±5.864°(P<0.01), with a difference of 3.200°±3.077°. There was no significant statistical difference in the differences of the two prism degree and the circular degree for concomitant esotropia and concomitant exotropia(P>0.05).CONCLUSIONS: The squint angle measured by different shaped prisms is different. The degree measured by right angle prism is larger than that by isosceles angle prism.
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AIM:To investigate the surgical method and extent of reoperation in the concomitant strabismus patients with surgical under-correction and over-correction. METHODS: Ninety - six concomitant strabismus patients with surgical under - correction and over -correction were recruited in this study, which included 41 males and 55 females, aged 21. 90±14. 70. All individuals underwent routine eye examinations for strabismus before the surgery. Among the cases with concomitant esotropia, there were over-correction in 23 cases, under-correction in 15 cases. Among the cases with concomitant exotropia, there were over-correction in 28 cases, under - correction in 30 cases. The method of reoperation were based on angle of deviation, the method of original operation and acute visual acuity of patients. RESULTS:In over - correction cases with concomitant esotropia, medial rectus muscle of 9 cases were advanced, the corrective extent was (5. 51±2. 63) ? / mm;9 cases were performed advance of medial rectus muscle and recession of lateral rectus muscle, the corrective extent was (6. 25±1. 59) ? / mm; 3 cases were performed resection of medial rectus muscle and recession of lateral rectus muscle, the corrective extent was (4. 26±1. 04) ? /mm; only 2 cases were performed recession of lateral rectus muscle, the corrective extent was (4. 21±1. 91) ? /mm. In under - correction cases with concomitant esotropia, 6 cases were performed resection of lateral rectus muscle, the corrective extent was (4. 03±0. 98) ? /mm; 6 cases were performed resection of lateral rectus muscle and recession of medial rectus muscle, the corrective extent was (6. 86 ± 1. 32) ? / mm; 3 cases were performed recession of medial rectus muscle, the corrective extent was ( 4. 33 ± 0. 29 ) ? / mm. In over -correction cases with concomitant exotropia, 16 cases were performed advance of lateral rectus muscle, the corrective extent was (5. 37 ± 1. 56) ? / mm; 6 cases were performed recession of medial rectus muscle, the corrective extent was (6. 29 ± 3. 68) ? / mm; 5 cases were performed advance of lateral rectus muscle and recession of medial rectus muscle, the corrective extent was (5. 46±1. 78) ? / mm; 1 case were performed resection of lateral rectus muscle, the corrective extent was 5. 00? / mm. In under - correction cases with concomitant exotropia, 12 cases were performed resection of medial rectus muscle, the corrective extent was (4. 47 ± 0. 54) ? / mm; 16 cases were performed recession of lateral rectus muscle and resection of medial rectus muscle, the corrective extent was ( 5. 11 ± 0. 75 ) ? / mm; 2 cases were performed recession of lateral rectus muscle, the corrective extent was (2. 65±0. 42) ? / mm. CONCLUSION: In reoperation of concomitant strabismus patients with over-correction, weakening or/and strengthening the horizontal muscle which were performed surgery before has a greater and more unstable surgical corrective extent. While In reoperation of concomitant strabismuspatients with under -correction, weakening or/ and strengthening the horizontal muscle which were not performed surgery has a normal corrective extent as usual.
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AlM:To observe the changes of binocular vision in V-pattern exotropia children before and after surgical correction, and the effect of training in reconstructing the binocular vision after surgical corrections.METHODS: Sixty V-pattern exotropia children were enrolled in this study and were divided into three groups according to their age:group A (4~6 years old), group B (7~9 years old), and group C (10~12 years old), 20 cases for each group. Patients received routine refraction and ophthalmic examinations. Distance and near deviation were measured by prism-covering method and synoptophore. The simultaneous perception and fusion were examined with a synoptophore, and the stereacuity was measured with stereograms ( Titmus) . The children who didn’t reconstruct binocular vision function 1wk after surgery received binocular vision training. The data were recorded before and 1 , 2, 4, and 8wk after surgery. RESULTS: Binocular vision significantly improved among the children after surgery in group A and B ( P0. 05). CONCLUSlON: V - pattern exotropia children can benefit from early surgical correction and training after surgery in reconstruct binocular vision.
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AIM:To explore the application of 10g/L cyclopentolate chloride eye drops in children, and to compare the different effectiveness of cycloplegia between 10g/L cyclopentolate chloride and atropine in Chinese children.METHODS:A total of 236 eyes of 118 children aged 3~12 years old were enrolled in this study including 80 eyes of 40 children with myopia, 156 eyes of 78 children with hyperopia and 146 eyes of 73 children combined with astigmatism. 10g/L cyclopentolate chloride eye drops were used once per 5min for 3 times and refractive diopter was obtained 1h after the last drop of cyclopentolate. Three days after that, 10g/L atropine was then used 1 time per night for 1wk and optometry was performed again. The children were divided into 3 groups ( myopia, hyperopia and astigmatism group ) according to the refractive status, in which astigmatism was independent of the degree of separation of cylinder statistics. The results of retinoscope refraction were then compared between 10g/L cyclopentolate and 10g/L atropine. RESULTS:The refractive diopter was -2. 25±1. 31D after 10g/L cyclopentolate eye drops and -2. 23±1. 32D after 10g/L atropine in myopic group. The refractive diopter was 1. 35±1. 19D and 1. 38±2. 00D in astigmastic group. No significant difference was found in myopic group and astigmastic group (P= 0. 109, P= 0. 374). While in the hyperopic group, the refractive diopter was 3. 76±2. 4D after 10g/L cyclopentolate eye drops, which was lower than that after 10g/L atropine 4. 39±2. 6D (P=0. 000). CONCLUSION: The results of this study suggest that 10g/L cyclopentolate chloride eye drops can be used in myopia and astigmatism children, and 10g/L atropine should be used in hyperopia children.
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<p><b>OBJECTIVE</b>To investigate the effect of androgen on microstructure and mechanics nature of bone in orchiechtomied (ORX) male rats and reveal its mechanism by using the Micro CT analysis, bone biomechanics test, bone histomorphometric parameter test, and total body bone mineral density (BMD) measured by dual-energy X-ray absorptiomery (DXA).</p><p><b>METHODS</b>Thirty 12-month-old male Wister rats were randomly divided into three groups including ORX, sham-operated (Sham) and androgen (AD) group, ten rats in every group. Total body BMD was measured by DXA. Femurs and vertebrae were then harvested at the 12 th week after ORX for micro-computed tomography (Micro CT), histology and biomechanical were tested.</p><p><b>RESULTS</b>The administration of testosterone may reverse the decreasing BMD of total body and may prevent the decreasing weight. The biomechanical values of Maximum load, Enery, Maximum stress, Elastic Modulus of AD group significantly enhanced compared with ORX group (P < 0.05). The results of histomorphometric parameters showed that cancellous bone volume, osteoblast-osteoid interface, linear extent of bone formation, mineralizing surfaces, mineral apposition rate increased in the therapy group.</p><p><b>CONCLUSION</b>Androgen can accelerate cancellous bone formation and bone turnover, improve bone microstructure and enhance bone intensity and BMD.</p>