高透氧硬性角膜接触镜矫正屈光参差性弱视后立体视功能的评估

An evaluation of stereoacuity among anisometropic amblyopia cured through rigid gas permeable lenses

目的分析经高透氧硬性角膜接触镜(rigid gas permeable contact lens,RGP)联合常规弱视治疗并随访3年的屈光参差性弱视眼的最佳矫正视力、立体视功能变化,评价RGP联合常规弱视治疗对屈光参差性弱视治愈后立体视功能的影响。方法将2003年1月-2004年12月在我科门诊诊断为屈光参差性弱视患儿43例,随机分为两组:A组22例,配戴高透氧硬性角膜接触镜;B组21例,配戴框架眼镜。戴镜后两组同时进行正规弱视综合治疗,总共随访3年。当弱视矫正后行远立体视、近立体视检查,对所得数据进行统计学分析。结果A、B组治愈率分别为90.91%(20/22)和61.91%(13/21),A组明显高于B组,两组差异有统计学意义(χ2=4.18,P<0.05)。A组立体视出现平均时间为治疗后(7.00±0.45)个月,B组立体视出现时间为治疗后(13.00±0.53)个月,A组早于B组。经秩和检验,A组具有的远立体视功能和近立体视功能均优于B组(P<0.01)。结论RGP矫正屈光参差性弱视安全、有效,有利于弱视矫正后双眼立体视功能的建立,为屈光参差性弱视的临床治疗提供有力工具。

Objective To evaluate stereoacuity after 3 years of wearing rigid gas permeable lenses （RGP） prescribed to cure anisometropic amblyopia. Methods Forty-three patients with anisometropic amblyopia were divided into two groups： group A （22 patients） wore RGPs and group B（21 patients） wore spectacles. Both groups underwent therapy for amblyopia by wearing a patch, etc. Patients were tested for distance-stereopsis with a synoptophore and for near-stereopsis with a stereo visual acuity plate to determine when corrected vision acuity reached 〉4.9. Results Recovery rates were different for groups A and B：90.91%（20/22） and 61.91%（13/ 21）, respectively. The results between the two groups were significantly different （Х^2=4.18, P〈0.05）. Stereo visual acuity was evident at （7.00±0.45）months after therapy in group A but at （13.00±0.53） months after therapy in group B. Analysis with a rank-sum of squares test showed that group A had better stereo visual acuity than group B （P〈0.01）. Conclusion RGPs are a safe and effective way to cure anisometropic amblyopia and can be helpful in restoring stereo visual acuity.