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Abstract
Purpose
To evaluate the compliance level of therapy and the change in exo-angle after 1 or 2 hours of part-time occlusion therapy in intermittent exotropia.
Methods
This retrospective study included 97 patients with intermittent exotropia who were followed-up for more than 6 months after their initial visit. We evaluated the exo-angle and prescribed either 1 hour or 2 hours of part-time occlusion therapy for the fixating eye. After 6 months, the exo-angle was reevaluated and compliance was examined. Patients were divided into 2 groups according to the occlusion therapy time: the 1-hour patching group (33 patients) and the 2-hour patching group (64 patients). Compliance and deviation angle were retrospectively reviewed and compared between the 2 groups. We evaluated the exo-an-gle of patients with compliance over 50% (1-hour patching group (31 patients), 2-hour patching group (51 patients)).
Results
The mean exo-angles on the first visit were 22.61 ± 5.78 PD (prism diopters) at distance and 22.88 ± 8.11 PD at close-range in the 1-hour patching group, and 26.17 ± 4.55 PD at distance and 25.27 ± 8.54 PD at close-range in the 2-hour patching group. The proportion of patients with compliance over 50% was higher in the 1-hour patching group (93.94%) than in the 2-hour patching group (79.69%, p = 0.013). There were significant decreases in distant and close-range deviation angles after part-time occlusion in patients with compliance over 50% in both groups (1-hour patching group distant p = 0.042, close-range p = 0.002; 2-hour patching group distant p < 0.001, close-range p < 0.001). The magnitude of deviation angle decrease was not statistically significant between the 2 groups (ANCOVA; distant p = 0.461, near p = 0.761).
Conclusions
One or 2 hours of part-time occlusion therapy in intermittent exotropia provided beneficial effects, including decreasing the deviation angle. The magnitude of deviation angle decrease, however, was not different between the 2 times of therapy. Compliance was higher in the 1-hour part-time occlusion therapy group. Therefore, 1-hour part-time occlusion therapy could be effective in patients with poor cooperation.
References
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Table 1.
Patient characteristics of 1 hour patching and 2 hour patching group
Table 2.
The deviating angles before and after part-time patching (prism diopters)
|
Part-time patching |
p-value | |||
|---|---|---|---|---|
| Before | After | |||
| 1 hour patching* (n = 31) | Distant deviation (PD) | 22.48 ± 8.15 | 19.71 ± 7.49 | 0.042 |
| Near deviation (PD) | 22.03 ± 5.47 | 19.65 ± 5.39 | 0.002 | |
| 2 hour patching* (n = 51) | Distant deviation (PD) | 26.47 ± 4.44 | 24.53 ± 4.80 | <0.001 |
| Near deviation (PD) | 25.59 ± 8.59 | 20.92 ± 7.01 | <0.001 | |
| Compliance under 50% (n = 15) | Distant deviation (PD) | 25.87 ± 5.17 | 25.60 ± 5.76 | 0.634 |
| Near deviation (PD) | 24.67 ± 8.25 | 25.20 ± 7.41 | 0.744 | |
Table 3.
Deviation angle changes after part-time occlusion therapy (prism diopters)
| 1 hour patching* (n = 31) | 2 hour patching* (n = 51) | p-value† | Adjusted p-value‡ | |
|---|---|---|---|---|
| Distant deviation angle | 2.39 ± 3.41 (-8~9) | 1.94 ± 3.51 (-5~12) | 0.791 | 0.461 |
| Near deviation angle | 2.77 ± 7.31 (-12~18) | 4.67 ± 9.16 (-10~32) | 0.529 | 0.761 |
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