不同隐斜类型近视患者配戴渐进多焦点镜片后疗效观察

Observation the curative effect of progressive addition lenses for different types of phoria with myopia

目的 了解渐进多焦点镜片对不同隐斜类型的近视患者配戴后的影响.方法 临床病例对照研究.选取2009年3月至2012年5月在攀枝花学院附属医院眼科就诊的近视患者,按其就诊顺序和病人选择不同镜片意愿分组,其中自愿配戴渐进多焦点镜片的近视患者100例为A组,并对其屈光度及近用隐斜度进行检查,其检查结果与96例年龄、屈光度等匹配的自愿配戴单光镜为B组近视患者相对照,分析其配戴不同镜片屈光度及隐斜度改变的量.结果 渐进多焦点组（A组）2年平均等效球镜增加量与单光镜片组（B组）增加量差异比较无统计学意义（P＞0.05）;配戴渐进多焦点镜片组显性外斜视的增加人数与配戴单光镜片组显性外斜视的增加人数差异比较有统计学意义（P＜0.05）,其中配戴多焦点镜片组中外隐斜近视患者平均等效球镜增加量与内隐斜近视患者增加量差异比较有统计学意义（P＜0.05）.结论 渐进多焦点镜片对内隐斜近视患者效果较好;长期配戴渐进多焦点镜片有增加显性外斜视的风险,青少年配戴前最好检查隐斜状态.

Objective To evaluate the effect of progressive addition lenses （PALs） for different types of phoria with myopia.Methods The myope who was treated in the ophthalmology department of Panzhihua University Affiliated Hospital from March 2009 to May 2012 were divided into two groups voluntary.There were 100 myope in group A wearing progressive addition lenses,and group B were wearing single-vision spectacle lenses were 96 myope.The refraction and degree of phoria were compared between two groups.Results After 2 years,the increased spherical equivalent refraction of two groups were no statistical difference （P 〉0.05）.But there was significant difference of the increased number of dominant exotropia between two groups （P 〈0.05）,and also there was significant difference of increased refraction between exophoria and esophoria in group A.Conclusions PALs is beneficial for esophoria with myopia.The risk of dominant exotropia was increasing for youngsters wearing PALs for a long time,so it is necessary to examine the esophoria before wearing PALs.