硬性透气性角膜接触镜对散光性弱视的矫治作用

Correcting evaluation of rigid gas permeable contact lens for astigmatic amblyopia

目的评价硬性透气性角膜接触镜(rigid gas per-meable contact lens,RGPCL)对儿童散光性弱视的矫治作用及其安全性。方法选取框架眼镜矫治效果欠佳的儿童散光性弱视23例(46眼),其中,单纯远视性散光5眼,复合远视性散光23眼,复合近视性散光14眼,混合散光4眼。依据框架眼镜矫正视力分为轻度弱视组(13眼),中度弱视组(22眼),重度弱视组(11眼)。所有患儿配戴高透气性RGPCL,随访12个月,观察其矫治作用。结果配戴RGPCL即时,矫正视力较框架眼镜提高1～4行,平均(2.7±0.9)行,达到或超过5.0者7眼(15.22%)。12个月后,28眼(60.87%)的矫正视力≥5.0,其中,轻度弱视组11眼(84.62%),中度弱视组17眼(77.27%),重度弱视组无一眼达到5.0。观察期内无严重角、结膜损伤以及感染等并发症发生,无因不能耐受而停戴者。结论RGPCL对儿童散光性弱视的矫治是有效而安全的,框架眼镜矫治效果欠佳者可优先选择RGPCL。

Objective To investigate the correcting evaluation and safety of rigid gas permeable contact lens （RGPCL） on astigmatic amblyopia in children. Methods Forty-six eyes of 23 children were fitting with RGPCL. Among them 5 eyes were simple hyperopic astimatism,23 eyes compound hyperopic astigmatism, 14 eyes compound myopic astigmatism and 4 eyes mixed astigmatism. According to the best corrected visual acuity with spectacle, the children were divided into slight amblyopia 13 eyes, moderate 22 eyes and severe 11 eyes. Results Visual acuity with RGPCL improved 1 to 4 lines, average （2.7±0.9） lines compared with spectacle, 7 eyes were 5.0 or better. Twelve months later, visual acuity equal to 5.0 or better in 28 eyes, among them 11 eyes were in slight amblyopic group and 17 in moderate group. While none in severe amblyopic group reached 5.0. There was no obvious conjunctival or corneal injury, infection, no patients droped out due to RGPCL intolerence. Conclusion RGPCL wearing is effective and safe for treating astigmatic amblyopia in children. RGPCL is a good choice for those whose visual acuity hardly improved by wearing spectacle.