Combined Accommodation and Fusional Training Paradigm Versus Prism Correction for Small-Angle Acute Acquired Comitant Esotropia: A Cohort Study.

IF 4.2 3区医学 Q2 OPHTHALMOLOGY

Ophthalmology and Therapy Pub Date : 2026-11-01 Epub Date: 2026-10-03 DOI:10.1007/s40123-026-01507-w

Shuyang Guo, Ling Ling, Ziqing Ding, Jingrong Liu, Yan Liu, Rui Liu, Zhi Chen, Chen Zhao, Sida Xi, Wen Wen

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引用次数: 0

Abstract

Introduction: This study explored 6-month ocular alignment and visual function outcomes associated with a combined accommodative and fusional training paradigm and compared them with outcomes observed after prism correction in patients with small-angle acute acquired comitant esotropia.

Methods: This prospective, single-center, nonrandomized cohort study enrolled 42 patients with small-angle acute acquired comitant esotropia. Following counseling regarding both treatment options, patients selected visual training (N = 22) or prism correction (N = 20). The training group completed a 6-month, two-step paradigm: accommodative facility training using ± 2.00 diopter flippers and computer-based fusional divergence training with red-blue glasses. The prism group received prism correction to relieve diplopia. Examinations were performed at baseline, 1 week, 1 month, 3 months, and 6 months.

Results: At 6 months, the training group achieved complete motor success (orthophoria without diplopia) in 16/22 (72.7%) at distance and 17/22 (77.3%) at near, compared with 0/20 at either fixation distance in the prism group. Functional success, defined as an ocular deviation of ≤ 5 PD at both distance and near without diplopia, was achieved in 20/22 (90.9%) of the training group versus 0/20 (0.0%) of the prism group. All patients in the prism group reported relief of diplopia during prism wear but persistent diplopia when assessed without prism correction. The training group also showed more favorable changes in several stereopsis and accommodative measures.

Conclusions: In this small nonrandomized cohort, preference-based selection of combined visual training was associated with more favorable 6-month outcomes than prism correction when outcomes were assessed without prism correction. These exploratory findings are hypothesis-generating and require confirmation in adequately powered randomized studies.

Trial registration: ClinicalTrials.gov identifier, NCT06622044.

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联合调节和融合训练模式与棱镜矫正治疗小角度急性获得性共同性内斜视：一项队列研究。

摘要：本研究探讨了调节和融合联合训练模式下6个月的眼线和视觉功能的相关结果，并将其与小角度急性获得性共同性内斜视患者棱镜矫正后的结果进行了比较。方法：这项前瞻性、单中心、非随机队列研究纳入了42例小角度急性获得性共同性内斜视患者。在咨询两种治疗方案后，患者选择视力训练（N = 22）或棱镜矫正（N = 20）。训练组完成了为期6个月的两步模式：使用±2.00屈光度脚蹼进行适应性设施训练和使用红蓝眼镜进行基于计算机的融合发散训练。棱镜组接受棱镜矫正，缓解复视。在基线、1周、1个月、3个月和6个月进行检查。结果：在6个月时，与棱镜组在任何固定距离均为0/20相比，训练组在16/22（72.7%）和17/22（77.3%）处实现了完全的运动成功（无复视的正斜视）。训练组的20/22（90.9%）和棱镜组的0/20（0.0%）实现了功能成功，定义为远视和近视眼偏差≤5pd，无复视。三棱柱组的所有患者都报告在佩戴三棱柱期间复视有所缓解，但在不矫正三棱柱时评估复视持续性。训练组在一些立体视觉和适应性措施上也表现出更有利的变化。结论：在这个小的非随机队列中，当评估结果时，基于偏好的联合视觉训练的选择比不进行棱镜矫正的结果更有利。这些探索性发现是假设产生的，需要在充分有力的随机研究中得到证实。试验注册：ClinicalTrials.gov识别码，NCT06622044。

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来源期刊

Ophthalmology and Therapy OPHTHALMOLOGY-

CiteScore

4.20

自引率

3.00%

发文量

157

审稿时长

6 weeks

期刊介绍： Aims and Scope Ophthalmology and Therapy is an international, open access, peer-reviewed (single-blind), and rapid publication journal. The scope of the journal is broad and will consider all scientifically sound research from preclinical, clinical (all phases), observational, real-world, and health outcomes research around the use of ophthalmological therapies, devices, and surgical techniques. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/series, trial protocols and short communications such as commentaries and editorials. Ophthalmology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. 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