Long-term outcomes of myopia control strategies in intermittent exotropia: A real-world study of myopia control spectacles and orthokeratology.

PURPOSE: This real-world study evaluated the effectiveness of myopia control spectacles (MCS) and orthokeratology (Ortho-k) in slowing myopia progression and supporting binocular function in children with intermittent exotropia (IXT), highlighting treatment outcomes from routine clinical practice.

METHODS

Clinical data were obtained from myopic children with IXT who completed at least two years of follow-up. After applying inclusion and exclusion criteria, 70 children were assigned to the MCS group. Using PSM, 82 and 76 children were included in the single-vision (SV) and orthokeratology Ortho-K groups, respectively.

RESULTS

After two years, both the MCS and Ortho-k groups demonstrated significantly less axial elongation and myopia progression compared to the SV group (both, P < 0.0001), with no significant difference between MCS and Ortho-k groups (P > 0.05). The MCS group also exhibited better preservation of distance and near stereoacuity than the Ortho-k (both P < 0.0001) and SV groups (P = 0.01 and P < 0.001, respectively). For distance exodeviation, the MCS group showed a smaller increase than the Ortho-k and SV groups (P < 0.01 and P < 0.0001, respectively), and the Ortho-k group displayed less increase than the SV group (P = 0.01). A similar pattern was observed for near exodeviation, and the difference between the MCS and Ortho-k groups approached significance (P = 0.05).

CONCLUSIONS

MCS and Ortho-K effectively slowed myopia progression in children with basic-type IXT. In this high-risk population, MCS may additionally help preserve binocular function. These findings provide a foundation for future studies extending to broader IXT populations.