弱视儿童调节和隐斜的研究

Study on the amplitude of accommodation and heterophoria in amblyopic children

目的研究远视性弱视儿童的调节和隐斜状态和矫正镜片对其调节和隐斜的影响。方法测定了30例远视性弱视儿童的调节幅度和裸眼及戴矫正镜片情况下看近的隐斜度,并与20名正视儿童进行对比。6月后重复检查其调节和隐斜情况,并进行比较和统计学分析。结果弱视组调节幅度为(12.35±1.30)D,正视组为(12.50±1.24)D,两者的差异无统计学意义(t=0.324,P>0.05)。弱视组裸眼隐斜度为(-1.37±4.77)△,戴矫正镜片时隐斜度为(-3.70±3.83)△,正视组隐斜度为(-3.95±3.30)△。经统计学分析,弱视组裸眼与戴矫正镜片时的隐斜度差异有统计学意义(t=3.675,P<0.01),弱视组裸眼与正视组隐斜度之间的差异有统计学意义(t=4.714,P<0.01),而弱视组戴矫正镜片时隐斜度与正视组隐斜度之间的差异无统计学意义(t=0.534,P>0.05)。6月后,弱视组调节幅度为(12.34±1.27)D,与6个月比较,前差异无统计学意义(t=0.376,P>0.05),裸眼的隐斜度为(-1.90±4.05)△,戴矫正眼镜的隐斜度为(-3.87±4.01)△,两者差异有统计学意义(t=4.308,P<0.01),但与6个月前相比较差异均无统计学意义。(裸眼t=1.859,P>0.05;戴镜t=1.526,P>0.05)。结论远视性弱视儿童戴矫正眼镜对调节功能没有明显影响,但可以使隐斜向外隐斜的方向偏移,有利于减少内隐斜。所以戴矫正眼镜不仅可以使视网膜成像清楚有利于弱视治疗,而且可以减少看近的内隐斜。

Objective To study the amplitude of accommodation, heterophoria and the effect of corrective lens on it in amblyopic children with hyperopia . Methods The amplitude of accommodation and the amount of heterophoria on near （33cm） fixation were determined without and with correcting spectacles in 30 amblyopic children with hyperopia and 20 emmetropic children, respectively. Results The mean values of the amplitude of accommodation were （12.35±1.30） D and （12.50±1.24）D respectively in the amblynpic group and the emmetropic group. There was no significant difference （t=0.324, P 〉0.05）. The heteropboria without and with correction were （-1.37±4.77）△ and （-3.70±3.83）△ respectively in amblyopic group, and that in emmetropic group was （-3.95±3.30）△. The difference of the means of heterophria between with and without correction in amblyopic group was significant （t=3.675,P〈0.01）, the difference of the means of heterophria between without correction in amblyopic group and in emmetropic group was significant （t=4.714, P〈0.01）, the difference of the means of heterophoria between with correction in amblyopic group and in emmetropic group was not significant （t=0.534,P〉0.05）. After 6 months the meat, value of the amplitude of accommodation are（12.34±1.27）△, the difference of the means of the amplitude of accommodation between before and after 6 months was not significant （t=0.376,P〉0.05）. The heterophoria without and with correction were （-1.90±4.05）△ and（- 3.87±4.01）△ ,respectively in amblyopic group. The difference of the means of heteropbria between with and without correction in amblyopic group after 6 months was significant （t=4.308,P〈0.01）, the corresponding diffcrence of the means of the heterophoria between after and before 6 months was not significant （t=1.859, P〈0.05 without correction, t=1.526,P〉0.05 with correction） . Conclusion The correcting spectacles may decrease the amount of esophoria. The image in the retina will be clear with correction, it will be beneficial to the treatment of amhlyopia.