굴절조절내사시에서 원시 굴절률의 장기변화

Abstract

Purpose: To analyze the long-term changes of hyperopic refractive error in patients with refractive accommodative esotropia. Methods: We retrospectively reviewed the medical records of 54 patients with accommodative esotropia who underwent at least36 months of follow-up and had hyperopia more than +1.50 diopter (D). The patients were divided into groups according to thedegree of hyperopia: +1.50~<+3.00 D, ≥+3.00~<+5.00 D, and ≥+5.00 D, the age of their first hyperopic glasses prescription:under two-years old, between two to four-years old and older than four years old, whether or not they had amblyopia, the degreeof astigmatism: <0.75 D, ≥0.75-<1.25 D, and ≥1.25 D and divided into two groups according to the degree of stereopsis: ≤400sec and >400 sec. The divided groups were than retrospectively reviewed if they influenced the refractive error at the third yearof follow-up using Fisher’s exact test, paired t-test, Wilcoxon’s signed-ranks test, Mann-Whitney U test, Kruskal-Wallis H test,and ANOVA (p < 0.05). Results: The mean follow-up period was 103.72 ± 41.82 months for refractive accommodative esotropia. Patients with a greaterinitial hyperopic refractive error showed a significant tendency towards emmetropization with a higher rate of hyperopic decrease(p < 0.001), regardless of the hyperopic refractive error. Statistical differences were not observed in patients who started wearingglasses after four-years old, patients with amblyopia, patients with a large degree of astigmatism, and patients with poor stereoacuity. Conclusions: Long-term changes of hyperopic refractive error in accommodative esotropia showed a significant decrease wheninitial hyperopic refractive error was high. Wearing hyperopic glasses at an older age and visual functions such as amblyopia,large degree of astigmatism, and poor stereoacuity may influence emmetropization.