调节性内斜视眼镜处方方法研究

The study of methods of spectacles prescription for accommodative esotropia

目的探讨调节性内斜视最佳配镜处方方法及疗效。方法55例调节性内斜视患儿,随机分为两组。A组:全矫组,28例,麻痹睫状肌后行远视全矫配镜。B组:同视机组,27例,麻痹睫状肌待瞳孔恢复后,在同视机上观察不同矫正镜片对斜视度、视功能的影响,选择达到双眼最佳融像、眼正位的度数配镜。采用卡方检验比较两组的配镜疗效。结果经3.5年跟踪观察,B组51.9%患儿配镜度数比总远视度低0.50D以上,平均(1.38±0.43)D;B组较A组配适好,脱镜现象少;B组远视度平均年降幅比A组大0.64D;两组立体视恢复率差异无统计学意义。结论调节性内斜视患儿在同视机及其客观检测指标的指导下进行配镜的方法,可能优于粗略的全矫配镜方法。

[Abstract] Objective To investigate the methods of spectacles prescription for accommodative esotropia and evaluate the effects of different methods. Methods Fifty-five accommodative esotropic children were divided into two groups randomly. Group A, full correction group, 28 children were provided with spectacles of entire correction after cycloplegia. Group B, synoptophore group, 27 children＇s refraction was done after cycloplegia, when pupil came back, observed the effects of different diopter to strabismus, visual function and etc in synoptophore test. Chose the ones which can keep the eyes orthotopic and offered the best binocular fusion. Results After 3.5 years＇ follow-up, 51.9% of patients＇ prescriptions in group B were at least 0.50 D [（1.38±0.43）D] less than total hyperopia diopter, and the rate of orthotopia was the same as group A. Children in group B felt more comfortable and more willing to accept spectacles. Diopter declined in group B was 0.64 D more than group A annually （P〈0.05）. There was no significant difference between the two groups in recovery of stereo perception （P〉0.05）. Conclusion Spectacles prescription guided by synoptophore and other objective tests are better than full correction in accommodative esotropic children.