Abstract

In this paper the optimum timing for the postoperative functional cure of basic intermittent exotropia is explored based on support vector machine (SVM). One hundred and thirty-two patients were recruited in this prospective cross-sectional study with 6 months of follow-up. Examinations included angle of deviation, central and peripheral fusion, controllability, and near and distance stereopsis. Influencing factors of postoperative alignment and stereopsis were analyzed with a chi-squared test and univariate and multivariate logistic regression analyses. At 6 months post-operation, there were 84 successful procedures for the angle of deviation, with 4 overcorrections and 44 undercorrections. The success rate was 63.6%. The angle of deviation on postoperative day 1 was the only significant associated factor. One hundred and thirty patients had normal near stereoacuity, 60 had normal distance stereoacuity according to a Functional Visual Analyzer assessment, and 108 had normal stereoacuity as assessed by the Frisby Davis Distance (FD2) stereotest. The age of onset and preoperative distance stereoacuity with FD2 were the influencing factors of postoperative distance stereopsis restoration. The accuracy of this method of SVM was 82.1%. The angle of deviation for distance on postoperative day 1 was the only significant factor that correlated with alignment at 6 months post-operation, and the model of SVM was useful to determine the optimal time of the postoperative functional cure.

Highlights

  • In this paper the optimum timing for the postoperative functional cure of basic intermittent exotropia is explored based on support vector machine (SVM)

  • A support vector machine (SVM) model was designed to show the optimal time for surgical intervention based on the preoperative factors and provide valuable clinical guidance

  • Intermittent exotropia (IXT) is a common type of strabismus in children

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Summary

Subjects and Methods

This study adhered to the principles of the Declaration of Helsinki and was approved by the ethics committee of the Tianjin Eye Hospital, PRC(YKLL-2015-8-21). Patients fulfilling the eligibility criteria were recruited from the pediatric eye clinic at Tianjin Eye Hospital, China, from September 2015 to March 2016. Baodi Clinical College, Tianjin Medical University, 8 Guangchuan Road, Tianjin, 301800, China. Participating clinicians managed children according to consistent normal clinical criteria. Surgical outcomes were deemed successful according to the angle of deviation at 6 months post-operation (esophoria/tropia ≤5 PD or exophoria/tropia ≤10 PD), recurrent (exotropia >10 PD) or overcorrected (esophoria/tropia >5 PD).

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