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Título

DEFOCUS LENSES AS AN OVERMINUS LENS IN INTERMITTENT EXOTROPIA

Resumo

Purpose: Overminus spectacle lenses (OSL) are an efficient and temporary non-surgical treatment option for intermittent exotropia (IXT). There is some debate if this treatment results in myopia development. This study evaluated the stability of IXT in participants using Defocus Incorporated Multiple Segments (DIMS) as an OSL. Methods: In this retrospective study, children with IXT aged 5 to 10 years old and with spherical equivalent refraction (SER) between -2.50 and +0.50 D were selected from medical records consecutive from Oftalmocenter Santa Rosa, Cuiabá, Brazil. The initial appointment occurred between January 2021 and May 2022. The general ophthalmologic exam included best visual acuity, cycloplegic refraction, cover test, ocular motility, and fundoscopy. During the first period, the participants were prescribed OSL based on the Kushner methods, which involved overminusing prescriptions by 2 D and incorporating base-in prisms of 2 Prism Diopters (PD) in each spectacle lens for 12 months. In the second period, the participants were prescribed DIMS spectacle lenses as the OSL too, for 12 months. The efficacy of treatment was assessed using the Newcastle Control System (NCS) before and after each period. This study was approved by the ethics committee of Centro Universitário da Várzea Grande, Brazil. Results: Twenty-one patients were selected, ten of which were male. The mean and standard deviation of the initial age, SER, and IXT deviations were 6.62 ± 1.53 years old, -0.82 ± 0.96 D, and 18.62 ± 4.70 PD, respectively. Following the first and second periods, the IXT deviation was 13.81 ± 4.69, and 12.57 ± 4.61 PD, respectively. There was a significant statistical difference between the treatment periods regarding the IXT deviation (t test p<0.0001), however, this was not clinically significant. Before treatment, after the first and the second periods, the mean NCS were 4.62 ± 0.74, 1.57 ± 0.75, and 1.10 ± 0.54, respectively. The scores in the treatment periods significantly improved from 4 to 1 (Bonferroni test p< 0.0001). Following the use of the DIMS as an OSL treatment, seventeen children (80.95%) showed a NCS score ≤ 1. Conclusion: In this study, using DIMS spectacle lenses as an OSL improved the control of IXT by the same rate as using OSL single vision. DIMS spectacle lenses could be a new treatment option in IXT associated with myopia control. Further randomized clinical trials may show the real improvement in myopia progression and deviation.

Referências Bibliográficas

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