Aim: To evaluate the efficacy and safety of trabeculectomy (Trab) with mitomycin-C (MMC) versus Trab with implant. Methods: Studies published in different languages were retrieved by systematically searching Embase, PubMed, Cochrane library, China Biology Medicine disc, and Google Scholar from 1966 to April 2018, as well as manually examining the references of the original articles. The outcome measures of efficacy covered intraocular pressure, glaucoma medications reductions, and success rate. Safety evaluation was measured by relative ratio of complications. Results: A total of 11 studies involving 443 participants were covered in this meta-analysis. The weighted mean difference (WMD) in the percentage of intraocular pressure (IOP) reduction (IOPR%) comparing Ologen group with MMC group was −3.69 (95% CI: −6.70 to −0.68) at 1 month, −2.69 (−5.17 to −0.21) at 3 months, −3.67 (−6.09 to −1.25)at 6 months, −3.24 (−6.08 to −0.41) at 12 months, 1.24 (−9.43 to 11.90) at 24 months, and 1.10 (−10.11 to 12.31) at 60 months, which showed that there was statistically significant difference at 1,3, 6, and12 months after the surgery. A significantly higher incidence of postsurgery hypotony (0.64 (95% Cl: 0.42 to 0.98)) and suture lysis (0.30 (95% CI: 0.10–0.93)) was observed in MMC group. However, there was no significant difference in the reduction in glaucoma medications, success rate, and incidence of other complications. Trab with 0.2 mg/mL MMC presented higher rates of complete success compared with Trab with 0.4 mg/mL MMC (P = .01). Conclusion: Trab with MMC was associated with a higher IOP-lowering efficacy and a higher incidence of postsurgery hypotony and suture lysis in contrast to that of Trab with Ologen.

Background: To compare the effect of alternate part-time patching and pencil push-up training on control ability in patients with intermittent exotropia. Methods: Patients (3–7 years old) with previously untreated intermittent exotropia were randomly assigned to receive alternate part-time patching, pencil push-up training, or observation. Control ability was assessed using the Office Control Score. Stereoacuity at 40 cm was evaluated with Titmus. Results were compared after a 12-week follow-up. Results: Ninety-two patients (28 in patching, 30 in pencil push-ups, and 34 in observation group) completed 12-week follow-up assessments. Based on 6-point scale, the mean deviation control was significantly better in patching and pencil push-up group after 12 weeks at distance (P = 0.002 and 0.026, respectively). Furthermore, there were greater control changes in patching and pencil push-up groups in comparison with observation group from baseline to 12 weeks (P<0.001; P = 0.003, respectively). After 12 weeks of treatment, stereoacuity and stereoacuity changes were not significantly different between either the intervention group or control group (P = 0.140 and 0.393, respectively). Conclusions: Based on the common office control scale, alternate part-time patching and pencil push-up training were effective treatment strategies for intermittent exotropia.

Background: Intermittent exotropia (IXT) is the most common type of strabismus, overminus lens (OML) therapy is frequently prescribed to treat IXT. Objectives: The purpose of this study was to compare the effectiveness of OML and observation in the treatment of IXT. Method: An exhaustive search of the literature in PubMed, Embase, Web of Science, and Cochrane Library databases was performed until July 2022. No language restrictions were used. The literature was rigorously screened according to eligibility criteria. Weighted mean differences and 95% confidence intervals (CIs) were calculated. Results: A total of 4 articles with 561 participants were included in this meta-analysis. Our pooled results showed that OML demonstrated superior outcomes compared with observation, with greater decreases in distance and near exodeviation control (MD = −1.08, 95% CI: −1.96 to −0.20, p = 0.02; MD, −0.64, 95% CI: −1.15 to −0.13, p < 0.001). Patients who received OML therapy had a greater decrease in the deviation at both distance and near (MD = −4.00, 95% CI: −7.03 to −0.98, p < 0.001; MD = −4.79, 95% CI: −6.29 to −3.30, p < 0.001). There was no statistical difference between the two groups in terms of post-treatment proximal stereopsis (MD, 0.00, 95% CI: −0.08 to 0.08, p = 1.00). Conclusions: The present meta-analysis indicated that OML therapy was effective in improving the control and decreasing exodeviation angle of IXT. However, it seemed not to be effective in improving the level of near stereopsis.

Accurate and objective tools for myopia screening in children and adolescents are crucial to retard progression and avert vision-endangering complications. This study aims to investigate the diagnostic performance of the axial length/corneal radius (AL/CR) ratio for myopia in children and adolescents. The literature search encompassed major electronic databases, key academic websites, and grey literature from inception to April 2025. Inclusion criteria were restricted to studies evaluating the diagnostic accuracy of AL/CR for myopia, with spherical equivalent (SE) ≤ -0.50 D as the gold standard for myopia diagnosis. The meta-analysis adhered to the Cochrane Handbook guidelines and PRISMA reporting standards. A total of 9 studies involving 24,030 children and adolescents were included in the meta-analysis. The summary sensitivity, specificity, and area under the curve of AL/CR for diagnosing myopia were 0.88 [95% CI: 0.86-0.90], 0.89 [95% CI: 0.86-0.91], and 0.93 [95% CI: 0.91-0.95], respectively. Meta-regression analysis revealed that the sensitivity of AL/CR remained independent of sample size, SE, myopia prevalence, age, or recruitment setting (school-based vs. hospital-based) (all p > 0.05). Notably, increased diagnostic specificity was significantly associated with older age (p = 0.01). The combination of AL/CR with non-cycloplegic autorefraction demonstrated significantly higher sensitivity and specificity in detecting myopia compared to AL/CR alone (Sensitivity: 0.93 [95% CI: 0.92-0.95] VS 0.88 [95% CI: 0.86-0.90]; Specificity: 0.94 [95% CI: 0.94-0.95] VS 0.89 [95% CI: 0.86-0.91]). AL/CR cut-off value exhibited significant correlations with age. AL/CR ratio demonstrates robust diagnostic efficacy for myopia in paediatric and adolescent populations, particularly when utilised in conjunction with non-cycloplegic autorefraction. However, the selection of age-specific AL/CR cut-off points is essential to maximise diagnostic precision.