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Guo S, Zhou Y, Xi S, Zhao C, Wen W. Advances in the diagnosis and treatment of acute acquired comitant esotropia. Int Ophthalmol 2024; 44:315. [PMID: 38967725 PMCID: PMC11226514 DOI: 10.1007/s10792-024-03231-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 06/18/2024] [Indexed: 07/06/2024]
Abstract
Acute acquired comitant esotropia (AACE) is mainly characterized by sudden onset, accompanied by diplopia, without extraocular muscles paralysis or ocular motility disorders. In recent years, the incidence of AACE has been increasing, researchers have found that this phenomenon may be related to the widespread use of electronic devices and the increase in the number of people working from home during the COVID-19 pandemic. However, its neural mechanisms have not been fully elucidated. This article primarily reviews the latest developments in the diagnosis and treatment of AACE from the perspectives of etiology and treatment methods, aiming to provide direction for future in-depth exploration of the pathogenesis and treatment approaches of this disease.
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Affiliation(s)
- Shuyang Guo
- Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
| | - Yulian Zhou
- Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
| | - Sida Xi
- Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, 200031, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
| | - Chen Zhao
- Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, 200031, China.
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.
- Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China.
| | - Wen Wen
- Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, 200031, China.
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.
- Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China.
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Yu X, Pan W, Tang X, Zhang Y, Lou L, Zheng S, Yao K, Sun Z. Efficacy of augmented-dosed surgery versus botulinum toxin A injection for acute acquired concomitant esotropia: a 2-year follow-up. Br J Ophthalmol 2024; 108:1044-1048. [PMID: 37620123 DOI: 10.1136/bjo-2023-323646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 08/08/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND/AIMS This study aims to evaluate the clinical efficacy of botulinum toxin type A (BTXA) injection and augmented-dosed surgery in the treatment of acute acquired concomitant esotropia (AACE), and explore potential risk factors associated with recurrence. METHODS A total of 104 patients diagnosed with AACE between October 2020 and January 2021 were included and voluntarily chose to undergo augmented surgery or BTXA injection. The follow-up assessments ended in November 2022. Multivariable linear regression analysis was used to identify potential factors that influence the dose-response of bilateral medial rectus recession (MRrec). Kaplan-Meier survival analyses and Cox proportional hazards models were performed to evaluate rate and risk factors for AACE relapse. RESULTS A total of 31 AACE patients chose augmented-dosed esotropia surgery, and 73 chose BTXA treatment. During the 2-year follow-up, the surgical group achieved more stable postoperative results with no recurrence of diplopia, while only 68.68% (95% CI 55.31% to 78.79%) patients achieved orthophoria in the BTXA group. For patients undergoing BTXA treatment, hours of near work per day were demonstrated to be a significant risk factor for AACE relapse (HR 1.29, 95% CI 1.00 to 1.67). The dose-response of augmented-dosed bilateral MRrec was positively correlated with preoperative deviation angle (R2=0.833; β=0.043, 95% CI 0.031 to 0.055; p<0.001). CONCLUSION Our findings provided quantitative evidence that augmented-dosed surgery would achieve more stable and favourable surgical outcomes for AACE patients compared with BTXA injection. However, BTXA treatment is still proposed for patients with small deviation angles due to its advantages of reduced trauma, operational simplicity, low cost and quick recovery.
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Affiliation(s)
- Xiaoning Yu
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
| | - Weiyi Pan
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
| | - Xiajing Tang
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
| | - Yidong Zhang
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
| | - Lixia Lou
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
| | - Sifan Zheng
- GKT School of Medical Education, King's College London, London, London, UK
| | - Ke Yao
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
| | - Zhaohui Sun
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
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Li Q, Fu T, Ma X, Ren C, Guo B, Li Z. Quantitative Evaluation of Binocular Visual Perception in Patients With Strabismus: An Observational Study. J Pediatr Ophthalmol Strabismus 2023; 60:120-130. [PMID: 35611820 DOI: 10.3928/01913913-20220324-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To quantitatively evaluate and compare binocular visual perception between normal individuals and patients with different types of strabismus using a binocular phase combination paradigm. METHODS A total of 117 participants were included in the study and were divided into the normal control group, exophoria group, comitant exotropia group, comitant esotropia group, and special strabismus group according to the type of strabismus. The effective contrast ratio (ECR) was measured to quantitatively evaluate binocular visual perception. Binocular fusion was evaluated using the Worth 4-dots flashlight. Stereoacuity was detected by the Titmus stereo test. RESULTS The mean ECRs in the normal control group, exophoria group, comitant exotropia group, comitant esotropia group, and special strabismus group were 0.896 ± 0.214, 0.824 ± 0.234, 0.520 ± 0.279, 0.261 ± 0.139, and 0.461 ± 0.243, respectively. Within-group differences in the ECR were statistically significant. In addition, there was no statistically significant difference between the normal control group and exophoria group, and the concomitant exotropia group and special strabismus group and the other groups were statistically significant in pairwise comparison. The binocular visual perception was basically balanced in the exotropia group and most imbalanced in the comitant esotropia group, followed by the comitant exotropia group and the special strabismus group. The results also indicated that the decreased ECR was related to poor stereopsis and ECR had a significant positive correlation with binocular fusion function. CONCLUSIONS Different types of strabismus have different degrees of visual perception imbalance. The binocular phase combination paradigm applied in this study can quickly and accurately quantify the degree of binocular visual perception imbalance in patients with strabismus by measuring ECR. [J Pediatr Ophthalmol Strabismus. 2023;60(2):120-130.].
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Yagasaki T, Yokoyama Y, Yagasaki A, Eboshita R, Tagami K, Haga Y, Touya A. Surgical Outcomes with and without Prism Adaptation of Cases with Acute Acquired Comitant Esotropia Related to Prolonged Digital Device Use. Clin Ophthalmol 2023; 17:807-816. [PMID: 36937166 PMCID: PMC10017831 DOI: 10.2147/opth.s403300] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 03/02/2023] [Indexed: 03/12/2023] Open
Abstract
Purpose To analyze surgical results of 32 cases with acute acquired comitant esotropia (AACE) related to prolonged use of digital devices (DDs). Patients and Methods Medical records of cases with AACE related to prolonged use of DDs that had undergone surgery were retrospectively revised. Complete medical history and full ophthalmological examinations before and surgery were obtained for all cases. All cases also underwent neurological examinations using brain and orbital imaging. Motor success was considered as alignment within 10 prism diopters (Δ) at both near and distance. Sensory success was defined as stereopsis ≤60 arcsec. Nineteen cases (Group S) underwent surgery alone and 13 cases were treated with surgery and prism adaptation (Group S+P). Motor and sensory outcomes were compared between groups. Results Mean age at first visit was 22.0 ± 9.0 years and mean daily use of DDs use was 6.3 ± 3.4 hours. Mean angle of preoperative alignment for distance and near were 26.5 ± 13.0Δ and 24.6 ± 16.4Δ, respectively. Surgery was performed at a mean of 23.3 ±3.5 years old and mean angle of alignment at final examination for distance and near were 5.8 ± 7.7Δ and 3.5 ± 5.7Δ, respectively. Final motor and sensory success rate were 84% and 53%, respectively. No significant differences in motor or sensory outcomes were evident between groups at initial or last visit. Conclusion Favorable motor and sensory outcomes were achieved with surgical intervention with and without prism adaptation for AACT related to prolonged use of DDs.
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Affiliation(s)
- Teiji Yagasaki
- Yagasaki Eye Clinic, Ichinomiya, Aichi, Japan
- Department of Ophthalmology, Japan Community Healthcare Organization Chukyo Hospital, Nagoya, Aichi, Japan
- Correspondence: Teiji Yagasaki, Yagasaki Eye Clinic, 62-6 Gonaka, Kaimei, Ichinomiya, Aichi, 494-0001, Japan, Tel +81-586-61-8787, Fax +81-586-61-9210, Email
| | - Yoshimi Yokoyama
- Department of Ophthalmology, Japan Community Healthcare Organization Chukyo Hospital, Nagoya, Aichi, Japan
| | - Ayaka Yagasaki
- Department of Ophthalmology, Japan Community Healthcare Organization Chukyo Hospital, Nagoya, Aichi, Japan
- Department of Ophthalmology, Gifu Prefectural General Medical Center, Gifu, Gifu, Japan
| | | | | | - Yayoi Haga
- Yagasaki Eye Clinic, Ichinomiya, Aichi, Japan
| | - Arisu Touya
- Yagasaki Eye Clinic, Ichinomiya, Aichi, Japan
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Pichler U, Schmidbauer E, Hermann P, Wagner H, Bolz M, Mursch‐Edlmayr AS. A comparative study of various prism adaptation forms in the surgical management of esophoria. Acta Ophthalmol 2022; 100:e1010-e1014. [PMID: 34431217 PMCID: PMC9291304 DOI: 10.1111/aos.15004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 07/07/2021] [Accepted: 08/04/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate the outcome in participants who underwent surgery for esophoria following one of three different methods of preoperative prism adaptation test (PAT). METHODS This prospective, multicentre study was carried out at five eye departments from 2012 to 2019. 116 participants were included and allocated to three groups as per investigator choice: Group 1 (n = 55) had a short prism adaptation period ranging from 1 to 5 hours during their visit at the clinic. Group 2 (n = 36) underwent partial prism correction for at least 4 weeks before surgery. Group 3 (n = 25) underwent full prism correction for at least 4 weeks before surgery. Motoric success was determined by postoperative angle of deviation (AOD), and sensoric success was evaluated with Lang and Bagolini striated lens test. RESULTS A significant increase (p < 0.001) in AOD after PAT was observed in all groups, with no significant difference between groups (distance: p = 0.22; near: p = 0.31). Motoric and sensoric success was comparable between groups 3 months (p = 0.52; p = 0.55) and 1 year (p = 0.53; p = 0.29) after surgery. Prolonged prism adaptation (n = 24) for more than 365 days was not associated with better results. CONCLUSION Our study indicates that the postoperative result is independent from the duration and amount (partial or full correction) of prism adaptation before surgery at least up to one year of follow-up. Prolonged prism adaptation (>365 days) before surgery does not improve the results.
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Affiliation(s)
- Ulrike Pichler
- Department for Ophthalmology Kepler University Hospital Johannes Kepler University Linz Austria
| | - Elke Schmidbauer
- Department for Ophthalmology Kepler University Hospital Johannes Kepler University Linz Austria
| | - Philipp Hermann
- Center for Clinical Studies (CCS Linz) Johannes Kepler University Linz Austria
| | - Helga Wagner
- Center for Clinical Studies (CCS Linz) Johannes Kepler University Linz Austria
- Institute of Applied Statistics Johannes Kepler University Austria
| | - Matthias Bolz
- Department for Ophthalmology Kepler University Hospital Johannes Kepler University Linz Austria
- Johannes Kepler University Linz Austria
| | - Anna Sophie Mursch‐Edlmayr
- Department for Ophthalmology Kepler University Hospital Johannes Kepler University Linz Austria
- Johannes Kepler University Linz Austria
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Gietzelt C, Fricke J, Neugebauer A, Hedergott A. Prism adaptation test before strabismus surgery in patients with decompensated esophoria and decompensated microesotropia. Int Ophthalmol 2022; 42:2195-2204. [PMID: 35038124 PMCID: PMC9287201 DOI: 10.1007/s10792-022-02219-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 01/04/2022] [Indexed: 11/24/2022]
Abstract
Purpose To evaluate the effect of Prism adaptation test (PAT) on the angle of squint in decompensated esophoria (decEPH) and decompensated microesotropia (decMET). Methods In this single-center retrospective study we reviewed the medical records of patients with the diagnosis of decEPH or decMET, aged at least 12 years, who were treated by strabismus surgery for the first time. The maximum Angle of squint (AOS) for far (F) and near (N) fixation and PAT results before surgery, as well as AOS (F) and AOS (N) after surgery and results of binocular function tests were considered. PAT included wearing a prism based on the largest angle for over 60 min. Results 100 patients (mean age 37 ± 17 years) were included in the decEPH group, 82 patients (mean age 30 ± 13 years) in the decMET group. For decEPH, before surgery AOS was 25.5 ± 8.8 pdpt (F) and 23.5 ± 9.8 pdpt (N). During PAT the AOS increased significantly by 2.7 ± 4.3 to 28.2 ± 8.6 pdpt (F) and by 4.9 ± 4.5 to 28.3 ± 9.5 pdpt (N). Altogether, in 82% of decEPH patients AOS (F) and/ or AOS (N) in- or decreased by at least 3 pdpt. For decMET, before surgery AOS was 28.6 ± 10.8 pdpt for far (F) and 30.9 ± 11.8 pdpt for near fixation (N). During PAT the AOS increased significantly by 4.2 ± 5.8 to 32.5 ± 9.5 pdpt (F) and by 3.7 ± 6.1 to 34.4 ± 9.5 pdpt (N). Altogether, in 51% of decMET patients, AOS (F) and/ or AOS (N) increased by at least 10 pdpt, therefore more than 5° which would have been maximally expected from mictrotropia, or decreased by at least 3 pdpt. Conclusions The Prism adaptation test (PAT) showed remarkable changes in AOS in both decEPH and decMET. In patients with decEPH, the preoperative assessment of the “true AOS” under PAT reflects a pivotal requirement for successful strabismus surgery, as 82% had dose relevant angle changes ≥ 3 pdpt. For patients with decMET the preoperative prism adaptation test is especially of diagnostic value, but also 51% of decMET patients had changes in AOS beyond the expected microtropic angle (≥ 10 pdpt) or even a dose relevant angle decrease (≥ 3pdpt).
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Affiliation(s)
- Caroline Gietzelt
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Julia Fricke
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Antje Neugebauer
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Andrea Hedergott
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
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Binocular visual function after unilateral versus bilateral implantation of segmented refractive multifocal intraocular lenses: a pilot study. Graefes Arch Clin Exp Ophthalmol 2021; 260:1205-1213. [PMID: 34825956 DOI: 10.1007/s00417-021-05496-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 11/07/2021] [Accepted: 11/10/2021] [Indexed: 10/19/2022] Open
Abstract
PURPOSE To evaluate binocular visual function after unilateral and bilateral implantation of segmented refractive multifocal intraocular lenses (MIOLs). METHODS This prospective comparative pilot study included patients who underwent SBL-3 (Lenstec; + 3.00 D) implantation at Peking University Third Hospital. Patients were divided into two groups (monocular or binocular surgery). Thirty-two patients with emmetropic presbyopic contralateral eyes and 49 patients with bilateral SBL-3 implantation within a week between eyes were included in the unilateral SBL-3 and bilateral groups, respectively. At 3-month follow-up, the main outcomes were binocular uncorrected distant, intermediate, and near visual acuity (UDVA, UIVA, and UNVA). Secondary outcomes included binocular best-corrected visual acuity at all distances, defocus curve, contrast sensitivity, photic phenomena, spectacle independence, patient satisfaction, and National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) score. The essential perceptual phenomena constituting binocular vision, simultaneous perception, fusion, and stereopsis were also evaluated. RESULTS Both groups showed similar binocular UDVA and UIVA, but UNVA was significantly better in the bilateral group (0.07 ± 0.07 versus 0.12 ± 0.07, P = 0.008). Better binocular defocus curve at intermediate to near focal points, higher percentage of spectacle independence at near distance, and NEI-VFQ-25 near activity scores were observed in the bilateral group. No significant differences in contrast sensitivity, photic phenomena, overall satisfaction, other NEI-VFQ-25 subscales, fusional amplitude, and stereoacuity were found between groups. CONCLUSION Unilateral implantation of segmented refractive MIOL provided desirable distant visual acuity and high patient satisfaction, but inferior intermediate and near visual outcomes compared with bilateral implantation.
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Dai Z, Zheng F, Xu M, Zhou J, Wan M, Yu H, Hou F, Chen J, Yu X. Effect of the base-out recovery point as the surgical target for acute acquired comitant esotropia. Graefes Arch Clin Exp Ophthalmol 2021; 259:3787-3794. [PMID: 34319423 DOI: 10.1007/s00417-021-05318-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 06/19/2021] [Accepted: 07/07/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To evaluate the treatment efficacy of the preoperative base-out recovery point as the surgical target angle for acute acquired comitant esotropia. METHODS Prospective study. Twenty-two patients with acute acquired comitant esotropia (AACE) underwent strabismus surgery based on the target angle of the preoperative base-out recovery point. The postoperative deviation, positive fusional vergence, and negative fusional vergence were evaluated and compared with those of 23 normal individuals. RESULTS The mean follow-up period was 18.68 ± 19.48 months. At the last follow-up, 19 (86.4%) of 22 subjects had orthophoria, whereas 3 (13.6%) had minimal esophoria. The postoperative angle of deviation was significantly smaller than the preoperative angle of deviation at near (P < 0.001) and distance (P < 0.001). Postoperative sensory fusion was significantly better than preoperative fusion at near (P < 0.001) and distance (P < 0.001). The postoperative stereoacuity improved significantly after the surgery at near (P < 0.001) and distance (P < 0.001). Compared with the controls, the convergence and divergence amplitudes in the AACE patients were similar at distance (P > 0.05) but were still narrower at near (P < 0.001). CONCLUSION Good alignment and binocular balance were obtained with the surgical target angle of the base-out recovery point in AACE.
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Affiliation(s)
- Zhiyue Dai
- The Eye Hospital of Wenzhou Medical University, No. 270, West Xueyuan Rd., Wenzhou, 325027, Zhejiang, China
| | - Fuhao Zheng
- The Eye Hospital of Wenzhou Medical University, No. 270, West Xueyuan Rd., Wenzhou, 325027, Zhejiang, China
| | - Meiping Xu
- The Eye Hospital of Wenzhou Medical University, No. 270, West Xueyuan Rd., Wenzhou, 325027, Zhejiang, China
| | - Jinjing Zhou
- The Eye Hospital of Wenzhou Medical University, No. 270, West Xueyuan Rd., Wenzhou, 325027, Zhejiang, China
| | - Minghui Wan
- The Eye Hospital of Wenzhou Medical University, No. 270, West Xueyuan Rd., Wenzhou, 325027, Zhejiang, China
| | - Huanyun Yu
- The Eye Hospital of Wenzhou Medical University, No. 270, West Xueyuan Rd., Wenzhou, 325027, Zhejiang, China
| | - Fang Hou
- The Eye Hospital of Wenzhou Medical University, No. 270, West Xueyuan Rd., Wenzhou, 325027, Zhejiang, China
| | - Jinmao Chen
- Department of Ophthalmology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Xinping Yu
- The Eye Hospital of Wenzhou Medical University, No. 270, West Xueyuan Rd., Wenzhou, 325027, Zhejiang, China.
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