三棱镜矫正联合融合训练治疗肌性视力疲劳的效果分析

Effects of prism combined with fusion training in muscular asthenopia

目的 观察三棱镜矫正联合融合训练对外隐斜引起的肌性视力疲劳的治疗效果。方法 对23例外隐斜导致肌性视力疲劳的患者进行屈光、隐斜、AC／A、融合功能检查后，在屈光矫正基础上应用压贴三棱镜矫正和融合功能训练。结果 随访10-42月，全部病例视疲劳症状得到明显的改善，眼胀痛、复视、头痛基本消失。治疗前持续阅读时间为12～35min，平均（25．1±6．2）min；治疗后为30～78min，平均（59．3±11．7）min，两者之间差异具有统计学意义（t=12．402，p=0．000）。治疗前远距正融合力为6～250，平均（12±7．5）^Δ；治疗后为7～320，平均（18．5±7．1）^Δ，两者之间差异具有统计学意义（t=30．11，p=0．004）。治疗前近距正融合力13～340，平均（22±10．2）^Δ，治疗后为16～39°，平均（28．6±8．8）°，两者之间差异具有统计学意义（t=2．155，p=0．024）。结论 三棱镜矫正联合融合训练能明显缓解外隐斜引起的肌性视力疲劳症状，不影响患者的融合功能。

Objective To observe the effects of prism combined with fusion training in the treatment of muscular asthenopia caused by exophoria. Methods 23 cases with muscular asthenopia caused by exophoria were included in our study. After examination of refraction, phoria, AC/A and fusion function, all cases were given prism correction and fusion training based on refraction correction. Results After followed up for 10-42 months, asthenopia was improved evidently in all cases, gas pains, diplopia and headache disappeared. Reading last 12-35 min before treatment, （25.1± 6.2）rain averagely; After treatment, it last 30-78 min, （59.3± 11.7） rain on average. THe difference between these was significantly （t=12.402, p=0.000）. Positive fusional power in the distance were 6-25^Δ, （12± 7.5）^Δ on average before treatment and 7-32^Δ, （18.5 ± 7.1）^Δ averagely after treatment. There was significant difference （t=3.001, p=0.004）. Before and after treatment, Positive fusional power in the near distance were 13-34^Δ（22 ±10.2）^Δ averagely and 16-39^Δ, （28.6 ±8.8）^Δ on average respectively. There was significant difference （t=2.155, p=0.024）. Conclusion Prism combined with fusion training may relieve obviously muscular asthenopia caused by exophoria without changing fusion function.