压贴三棱镜在不同类型双眼复视患者中的应用

Application of fresnel prism in patients with different types of binocular diplopia

目的:探讨压贴三棱镜在不同类型双眼复视患者中的干预效果。方法:回顾性病例研究。收集2018-06/2020-11在广东省江门市中心医院眼科接受压贴三棱镜干预的20例双眼复视患者,其中8例为急性共同性内斜视,5例为甲状腺相关性眼病,7例为因颅神经麻痹所致的斜视。分别于干预前后测斜视度和近立体视功能,调查干预前后患者视疲劳症状和独立驾驶能力。结果:经过压贴三棱镜干预后,全部患者的斜视度明显减少,与干预前比较变化有差异(P<0.05)。在急性共同性内斜视和颅神经麻痹的斜视中,近立体视功能得到恢复的患者明显增多,与干预前比较变化有差异(P<0.05)。在甲状腺相关性眼病患者中,干预前后近立体视功能变化无差异(P>0.05)。经过压贴三棱镜干预后,15例视疲劳症状明显缓解,13例独立驾驶能力恢复,与干预前比较变化有差异(均P<0.05)。结论:压贴三棱镜有效减少复视患者的斜视度,改善近立体视功能,提高生活质量。

AIM:To discuss the efficacy of fresnel prism in different types of binocular diplopia patients.METHODS:This retrospective study reviewed 20 patients who received fresnel prism treatment between June 2018 and November 2020 in Jiangmen Central Hospital.Eight of them were diagnosed as acute acquired comitant esotropia,five patients were thyroid-associated ophthalmopathy,and seven patients were eye misalignment caused by cranial nerve palsies.The outcome measures were deviation,near stereoacuity,asthenopia and driving ability at pre-treatment and post-treatment.RESULTS:The deviations were decreased after treatment.There were significant differences between pre-treatment and post-treatment(P<0.05).The patients with acute acquired comitant esotropia or eye misalignment caused by cranial nerve palsies recovered near stereoacuity meanwhile significant difference between before and after treatment(P<0.05).There were no significant differences between before and after treatment in patients with thyroid-associated ophthalmopathy(P>0.05).Thirteen patients recovered in the driving ability while fifteen patients were cured of asthenopia.There were significant differences between before and after treatment(all P<0.05).CONCLUSION:Fresnel prism treatment could decrease deviations in binocular diplopia patients,improved near stereoacuity and quality of life.