Background Intermittent exotropia (IXT) is the most common type of strabismus, overminus lens therapy (OML) is frequently prescribed to treat IXT. Objectives To compare the effectiveness of OML and observation in the treatment of intermittent exotropia. 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 (WMD) and 95% confidence intervals (CI) 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; OR, -0.64, 95%, -1.15 to -0.13; P

The Author(s). Published by S. Karger AG, Basel