Intermittent exotropia evaluation using the propedeutics proposed by Kushner: a 25-year study

ABSTRACT Purpose: To evaluate the clinical and surgical impacts of phenomena that could occur in intermittent exotropia. Methods: The medical records of intermittent exotropia cases from 1991 to 2014 were retrospectively reviewed. All patients underwent a series of measures, including a protocol to assess monocular occlusion based on the propedeutics proposed by Kushner. Results: Outdoor sensitivity was observed in 31% of patients with an undercorrection rate of 44% vs. 18% of cases with no outdoor sensitivity. After 1 h of monocular occlusion, 41% of all patients achieved an increase in deviation with an undercorrection rate of 40%, whereas 25% did not. Conclusion: The results show the importance of complete propedeutics, since there is a higher rate of late undercorrection in cases with outdoor sensitivity and increased deviation after occlusion.摘要 研究目的：评估间歇性外斜视（intermittent exotropia）可能出现的各类相关现象对患者临床诊疗及手术预后的影响。 研究方法：回顾性分析1991年至2014年间收治的间歇性外斜视患者的病历资料。所有患者均接受系列检查评估，其中包含基于库什纳（Kushner）提出的初步诊断方案所制定的单眼遮盖评估流程。 研究结果：31%的患者表现出户外敏感性，该类患者的欠矫率为44%；而无户外敏感性的患者中仅18%存在欠矫情况。在单眼遮盖1小时后，全部患者中有41%的斜视度出现升高，此类患者的欠矫率为40%，剩余25%的患者未出现该变化。 研究结论：本研究结果证实了完整初步诊断流程的重要性——存在户外敏感性表现以及单眼遮盖后斜视度升高的患者，其术后晚期欠矫的发生率显著更高。