Study On Binocularity Of Patients With Large-angle Intermittent Exotropia And Evaluation Of Quality Of Life In Children

Objective:To evaluate the difference of binocularity children and adults with large angle intermittent exotropia,and the improvement of quality of life of children and parents.Methods:This study was a prospective study.A total of 65 patients with complete data were included in the study.A total of 56 patients met the success criteria at 6 months after surgery.There were 29 cases in the children group,including(40-90)~△group:16 cases,aged(8.75±2.32)years(5-12)years.≥90~△group:13 cases,aged(9.85±1.82)years(7-13years).There were 27 cases in the adult group,including-(40-90)~△group:1 cases,aged(24.18±4.92)years(19-35 years).≥90~△group:16 cases,aged(27.75±5.41)years(23-39years).Visual function examination,fusion function using Worth4 light.The near stereopsis was examined by Titmus,and the distance stereopsis was examined by DISTANCE Randot Stereotest(developed by Professor Eileen Birch,from Stereo Optical Company,USA).All patients completed the above examinations before and 6 months after surgery.Quality of life(HRQo L)examination:All patients and parents in the children group were investigated by the Chinese version of the Intermittent Exotropia Quality of Life Assessment Scale(CIXTQ)before and 6 months after surgery.Results:1.Binocularity:(1)Comparison of preoperative children group:Compared with the≥90~△group,the proportion of patients with normal near stereopsis in the(40-90)~△group(3/13[23.08%]vs12/16[75%];P=0.009),and the proportion of patients with normal distance stereopsis(2/13[15.38%]vs6/16[60%];P=0.022)are higher.(2)Comparison of preoperative adult group:Compared with the≥90~△group,the proportion of patients with central fusion in the(40-90)~△group before operation(5/16[31.25%]vs9/11[81.82%])and the proportion of patients with peripheral fusion(3/16[18.75%]vs7/11[63.64%];P=0.040)are higher.(3)Comparison before and after operation in≥90~△group:Compared with the adult group,the proportion of patients with central fusion in the children group(5/16[31.25%]vs10/13[76.92%];P=0.025)and the proportion of patients with peripheral fusion(3/16[18.75%]vs8/13[61.54%]);P=0.027)are significantly higher.(4)Preoperative and postoperative comparison:the proportion of patients with central fusion,peripheral fusion,normal near stereopsis and normal distance stereopsis in patients with XT significantly increased after 6 month(all P<0.05).2.Quality of life of children and parents:(1)Compared with the≥90~△group,the(40-90)~△group’s parents surgery scale score(28.84±25.71vs60.15±21.02;P=0.001)are higher reoperatively(2)Compared with the≥90~△group,the(40～90)~△group’s parents surgery scale score(49.03±37.31vs71.87±19.09;P=0.042)are higher preoperatively(3)The scores of children’s scale,parental agency scale and parental scale before operation were significantly higher than those before operation(all P<0.05).Conclusion:1.The number of patients with binocularity in adult and children with large angle IXT increased significantly after 6 months of surgical treatment.2.The stereopsis of children in the(40-90)~△group was better than that in the≥90~△group,and the fusion of adults in the(40-90)~△group was better than that in the≥90~△group.3.Surgery can improve the quality of life of 5～13 years old IXT children and parents.Surgery can improve the HRQo L of IXT children and their parents aged 5-13 years.The HRQo L of parents of children with≥90~△IXT is lower,and they are more concerned about whether children need surgery.4.For patients with large-angle IXT,we cautiously advocate timely surgery,which is conducive to improving the quality of life of children and parents and the reconstruction of binocular visual function.