儿童微小内斜视的治疗及其疗效观察

Observation of the treatment and curative effect of children's microtropia

目的:寻求治疗儿童微小内斜视的有效疗法。方法:使用压贴三棱镜抵消30例微小内斜视性弱视儿童的内斜视度,同时使用综合疗法治疗弱视。并对本组患者进行了12～48mo的随访观察。结果:弱视治愈10例(33%),好转12例(40%),无效8例(27%)。总有效率73.33%。11例旁中心注视有8例(73%)转变为中心注视;12例异常视网膜对应有10例(83%)转变为正常视网膜对应。有近距离立体视的人数从6例(20%)增加到23例(77%)(χ2=19.28,P<0.01)。有远距离立体视的人数从13例(43%)增加到21例(70%)(χ2=4.34,P<0.05)。结论:用压贴三棱镜抵消微小内斜视患者的斜视度,有利于治疗旁中心注视及异常视网膜对应,有利于建立立体视功能。在使用压贴三棱镜矫正斜视的同时使用综合疗法治疗微小斜视性弱视,效果良好。

AIM： To explore an effective treatment for children＇s microtropia. METHODS： The esotropia degree was offseted by press- on prism, and amblyopia was treated by combined treatment in 30 patients with Microtropia. The follow-up time was 1-4 years. RESULTS： In this group, 33% （10/30） patients were cured; 40% （12/30） improved, and 27% （8/30） failed. Total efficiency was 73.33%. 8 of 11 patients （73%） with parafovea fixation turned into central fixation. 10 of 12 patients（83%） with abnormal retina corresponding turned into normal retina corresponding. The number of patients who had near stereopsis increased from 6 （20%） to 23 （77%） （Χ^2 = 19.28, P 〈 0.01 ） ; The n u m ber of patients who had distant stereopsis increased from 13 （43%） to 21 （70%） （Χ^2 =4.34,P〈0.05）. CONCLUSION： Use of Press-on prism benefits the converting from parafovea fixation to central fixation, the converting from abnormal retina corresponding to normal retina corresponding and the process of building stereopsis. At the same time, use of Press-on prism is effective to treat most of the patients with amblyopia , especially when it combined with combined therapy.