Clinical ophthalmology (Auckland, N.Z.) · 2026
Near Fixation-Associated Intraocular Pressure Reduction in Intermittent Exotropia: Postoperative Changes After Strabismus Surgery.
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Suzuki Takafumi, Fukutome Takao, Otaki Chisato, Ueta Yoshiki, Suzuki Tone
Аннотация
PURPOSE: To investigate changes in intraocular pressure (IOP) associated with accommodation in patients with intermittent exotropia (X(T)), and to evaluate how these changes are affected by strabismus surgery.
PATIENTS AND METHODS: Thirty-one consecutive patients scheduled for strabismus surgery due to X(T) were retrospectively analyzed. IOP was measured using a rebound tonometer (iCare) during strabismus examinations under three conditions: binocular viewing at distance (bIOP-D), binocular viewing at near (bIOP-N), and monocular viewing at near (mIOP-N). Correlations were assessed between IOP changes and accommodation-related parameters, including patient age and the change in angle of deviation (AOD) from distance to near. Postoperative alterations in these IOP dynamics were also investigated.
RESULTS: AOD at near was significantly greater than that at distance (p < 0.0001). bIOP-N was significantly lower than bIOP-D in both the non-fixation eyes (p = 0.017) and fixation eyes (p = 0.003). The decrease in IOP from distance to near under binocular viewing (Δd-nIOP) correlated significantly with age in fixation eyes (p = 0.007, r = -0.473). Δd-nIOP was also significantly correlated with the increase in AOD from distance to near fixation in both non-fixation (p = 0.017, r = 0.424) and fixation eyes (p = 0.002, r = 0.544). Postoperatively, no significant differences between bIOP-D and bIOP-N were found at 1 month (p = 0.230) or 6 months (p = 0.309).
CONCLUSION: In patients with X(T) who exhibited a larger AOD at near than at distance, near fixation led to a significant IOP reduction. This near-fixation-associated IOP decrease was less evident after strabismus surgery, particularly in non-operated eyes. These findings suggest that ocular alignment and accommodative demand may interact to influence IOP, although confirmation in larger studies is warranted.
PATIENTS AND METHODS: Thirty-one consecutive patients scheduled for strabismus surgery due to X(T) were retrospectively analyzed. IOP was measured using a rebound tonometer (iCare) during strabismus examinations under three conditions: binocular viewing at distance (bIOP-D), binocular viewing at near (bIOP-N), and monocular viewing at near (mIOP-N). Correlations were assessed between IOP changes and accommodation-related parameters, including patient age and the change in angle of deviation (AOD) from distance to near. Postoperative alterations in these IOP dynamics were also investigated.
RESULTS: AOD at near was significantly greater than that at distance (p < 0.0001). bIOP-N was significantly lower than bIOP-D in both the non-fixation eyes (p = 0.017) and fixation eyes (p = 0.003). The decrease in IOP from distance to near under binocular viewing (Δd-nIOP) correlated significantly with age in fixation eyes (p = 0.007, r = -0.473). Δd-nIOP was also significantly correlated with the increase in AOD from distance to near fixation in both non-fixation (p = 0.017, r = 0.424) and fixation eyes (p = 0.002, r = 0.544). Postoperatively, no significant differences between bIOP-D and bIOP-N were found at 1 month (p = 0.230) or 6 months (p = 0.309).
CONCLUSION: In patients with X(T) who exhibited a larger AOD at near than at distance, near fixation led to a significant IOP reduction. This near-fixation-associated IOP decrease was less evident after strabismus surgery, particularly in non-operated eyes. These findings suggest that ocular alignment and accommodative demand may interact to influence IOP, although confirmation in larger studies is warranted.