渐进多焦点镜矫治屈光性调节性内斜视

Clinical practice of wearing progressive addition lenses to correct refractive accommodative esotropia

目的观察渐进多焦点镜在矫治屈光性调节性内斜视合并弱视中的疗效及其对眼球正视化的影响。方法两组屈光性内斜视合并弱视的患儿。第1组:全矫和配戴渐进多焦点镜,视近区远视全部矫正,共41例;第2组:欠矫和配戴单焦点镜,弱视眼的远视欠矫度数为减去检影度数的1/3或1～2DS。戴镜后采用传统遮盖联合其他弱视综合治疗方法。观察治疗前后视力、眼位和屈光状态等的变化情况。结果全矫组患儿34例眼位良好,7例眼位回退,无1例合并间歇性外斜视。全矫组患儿的弱视眼视力恢复至1.0,健眼遮盖的时间平均是(7.3±3.12)个月,而欠矫组需要(10.3±3.21)个月,全矫组遮盖时间平均缩短3个月,两组差异有非常显著性(P<0.01)。治疗前全矫组平均屈光度为(+5.13±1.99)D,治疗后为(+4.20±1.86)D。结论与普通眼镜相比,渐进多焦点眼镜矫治屈光性内斜视合并弱视效果明显。在治疗期间,远视性屈光不正得到全部矫正,有利于视力和眼位的恢复,并可缩短疗程,且不影响眼球的正视化。

Objective To observe the effect of progressive addition lenses （PALs） to carrect refractive accommodative esotropia （RAET） on amblyopia. Children with refractive accommodative esotropia were divided into two groups. The PAL group consisted of 41 children who wore progressive addition lenses that provided full correction in the neor reading range; the SV group, with single vision lenses, were undercorrected by one third d cycloplegic retinoscopy measurements （1 - 2 diopters）. Traditional patching and comprehensive vision training therapy were used to treat amblyopia with glasses. Improvements in visual acuity, ocular alignment and refractive error were evalonted.Results In the PAL group, 34 cases were orthophoric, 7 cases had deteriorated RAET and no patient had intermittent exottropia. Best corrected ritual acuity for all patients increased to 1.0 and the average time for visual therapy was 7.3 months for the PAL group, but was 10.3 months for the SV group. Conclusion The effects of wearing multi-focal spectacles with full correction for accommodative esotropia on amblyopia are significant.