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

Cont Lens Anterior Eye. 2025 Apr;49(2):102626. doi: 10.1016/j.clae.2026.102626. Epub 2026 Feb 11.

ABSTRACT

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.

PMID:41679075 | DOI:10.1016/j.clae.2026.102626