A pilot randomized trial evaluating overminus spectacles versus part-time occlusion for control of intermittent exotropia among children 2–10 years of age

Abdelfatah, Merna G; Mahmoud, Ahmed T.I; Salman, Abdelrahman Gaber; ElSebaay, Marwa E

doi:10.4103/ejos.ejos_8_18

Cited by 5 publications

(9 citation statements)

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“…They developed an algorithm to achieve a practically personalized customization of the OML requirement for the treatment of IXT children for individuals and revealed the efficiency of OML therapy in improving distance control, angle of deviation, and stereopsis. Abdelfatah et al [8] carried out a study covering 60 children with IXT, from 2 to 10 years of age, which compared the overminus spectacles versus the typical OBS on short-term effectiveness in improving the control of IXT. Significant improvement was revealed in distance exotropia control score, near and distance angles after 4 months overminus spectacles therapy.…”

Section: Resultsmentioning

confidence: 99%

“…OML therapy for IXT is a frequently prescribed nonsurgical treatment modality. Recently, several randomized controlled trials (RCTs) have directly compared OML with OBS (watchful waiting), with mixed results [3‒9]. A meta-analysis was undertaken to assess the overall efficacy of OML in the control of IXT and the change in the angle of deviation.…”

Section: Introductionmentioning

confidence: 99%

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The Influence of Overminus Lens Therapy on Control of Intermittent Exotropia: A Meta-Analysis of Randomized Clinical Trials

Song

Qian

et al. 2023

Ophthalmic Res

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Background Intermittent exotropia (IXT) is the most common type of strabismus, overminus lens therapy (OML) is frequently prescribed to treat IXT. Objectives To compare the effectiveness of OML and observation in the treatment of intermittent exotropia. Method An exhaustive search of the literature in Pubmed, EMBASE, Web of Science, and Cochrane Library databases was performed until July 2022. No language restrictions were used. The literature was rigorously screened according to eligibility criteria. Weighted mean differences (WMD) and 95% confidence intervals (CI) were calculated. Results A total of 4 articles with 561 participants were included in this meta-analysis. Our pooled results showed that OML demonstrated superior outcomes compared with observation, with greater decreases in distance and near exodeviation control (MD=-1.08, 95% CI: -1.96 to -0.20, P=0.02; OR, -0.64, 95%, -1.15 to -0.13; P < 0.001). Patients who received overminus lens therapy had a greater decrease in the deviation at both distance and near (OR, -2.88; 95% CI, -3.75 to -2.01, P < 0.001; OR, -3.44; 95% CI, -5.34 to -1.55; P < 0.001). There was no statistical difference between the two groups in terms of post-treatment proximal stereopsis (OR=0.01, 95% CI: -0.04 to 0.05, P=0.83). Conclusions The present meta-analysis indicated that overminus lens therapy was effective in improving the control and decreasing exodeviation angle of intermittent exotropia. However, it seemed not to be effective in improving the level of near stereopsis.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Influence of Overminus Lens Therapy on Control of Intermittent Exotropia: A Meta-Analysis of Randomized Clinical Trials

Song

Qian

et al. 2023

Ophthalmic Res

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“…They revealed the efficiency of PTO therapy in improving deviation control in comparison with observation. Abdelfatah et al carried out a study covering 60 children with IXT, from 2 to 10 years of age, which compared the PTO versus observation on short-term effectiveness in improving the control of IXT [7]. Significant improvement was revealed in distance exotropia control but not in near exotropia control and distance exodeviation after 4 months PTO therapy.…”

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

The Influence of Part-Time Occlusion Therapy on Control of Intermittent Exotropia: A Meta-Analysis of Randomized Controlled Trials

Song¹,

Yang²,

Qian³

et al. 2023

Ophthalmic Res

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Objective To compare the effectiveness of part-time occlusion therapy（PTO） and observation in the treatment of intermittent exotropia(IXT). Methods An exhaustive search of the literature from Pubmed, EMBASE, Web of Science, and Cochrane Library databases was carried out until July 2022. No language restrictions were applied. The literature was rigorously screened against eligibility criteria. Weighted mean differences (WMD) and 95% confidence interval (CI) was calculated. Results A total of 4 articles with 617 participants were included in this meta-analysis. Our pooled results showed that PTO exhibited superior effects compared to observation, with greater decrease in exotropia control at distance and near (MD=-0.38, 95% CI: -0.57 to -0.20, P<0.001; MD=-0.36, 95%CI, -0.54 to -0.18, P<0.001), patients subjected to PTO therapy had greater decrease in distance deviations (MD=-1.95, 95% CI: -3.13 to -0.76, P=0.001). And there was greater improvement in near stereoacuity among PTO group in comparison with observation group (P<0.001). Conclusion The present meta-analysis indicated that part-time occlusion therapy showed a better effect in improving control and near stereopsis, and decreasing distance exodeviation angle of children with intermittent exotropia in comparison with observation.

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“…In a randomized clinical trial on 358 children aged 3 to 10 years with untreated intermittent exotropia, compliance with patching was judged to be excellent or good in 141 participants (88%) at the 6-month outcome visit [15]. Merna found that 27% of patients in the parttime patching therapy group were considered to have good adherence [18]. Scheiman reported that 61.5% of patients in the pencil push-up group performed their home therapy 75% of the time at 8 weeks [19].…”

Section: Discussionmentioning

confidence: 99%

“…In another study, therapists estimated that 73% of the patients performed pencil push-up training 75% of the time at 12 weeks [18]. Considering that children's low adherence to patching or pencil push-ups may affect treatment outcomes, this issue requires necessary action.…”

Section: Discussionmentioning

confidence: 99%

Comparison of alternate part-time patching and pencil push-up training for patients with intermittent exotropia

Song

Chen

et al. 2022

BMC Ophthalmol

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Background To compare the effect of alternate part-time patching and pencil push-up training on control ability in patients with intermittent exotropia. Methods Patients (3–7 years old) with previously untreated intermittent exotropia were randomly assigned to receive alternate part-time patching, pencil push-up training, or observation. Control ability was assessed using the Office Control Score. Stereoacuity at 40 cm was evaluated with Titmus. Results were compared after a 12-week follow-up. Results Ninety-two patients (28 in patching, 30 in pencil push-ups, and 34 in observation group) completed 12-week follow-up assessments. Based on 6-point scale, the mean deviation control was significantly better in patching and pencil push-up group after 12 weeks at distance (P = 0.002 and 0.026, respectively). Furthermore, there were greater control changes in patching and pencil push-up groups in comparison with observation group from baseline to 12 weeks (P<0.001; P = 0.003, respectively). After 12 weeks of treatment, stereoacuity and stereoacuity changes were not significantly different between either the intervention group or control group (P = 0.140 and 0.393, respectively). Conclusions Based on the common office control scale, alternate part-time patching and pencil push-up training were effective treatment strategies for intermittent exotropia.

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A pilot randomized trial evaluating overminus spectacles versus part-time occlusion for control of intermittent exotropia among children 2–10 years of age

Cited by 5 publications

References 1 publication

The Influence of Overminus Lens Therapy on Control of Intermittent Exotropia: A Meta-Analysis of Randomized Clinical Trials

The Influence of Overminus Lens Therapy on Control of Intermittent Exotropia: A Meta-Analysis of Randomized Clinical Trials

The Influence of Part-Time Occlusion Therapy on Control of Intermittent Exotropia: A Meta-Analysis of Randomized Controlled Trials

Comparison of alternate part-time patching and pencil push-up training for patients with intermittent exotropia

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