屈光性调节性内斜视儿童戴镜后的屈光演变

Effects of spectacle wear on the development of refractive changes in children with accommodative esotropia

目的探讨屈光性调节性内斜视儿童戴镜后屈光状态随年龄的变化规律，为临床随访时间及配镜提供依据。方法回顾我院65例（130眼）屈光性调节性内斜视儿童连续多年的屈光数据，对主导眼和非主导眼的屈光度比较采用配对t检验，对屈光度差值与观察期进行直线回归分析。结果等效球镜度、球镜度、散光度差值与月龄存在直线回归关系（P〈0．01）。主导眼和非主导眼等效球镜度月平均分别减少0．015 D和0．012 D；等效球镜度改变规律为远视度先增加后减少，而后有逐渐向近视方向发展的趋势；转变年龄为3．58～4．90岁；散光度月平均演变速度仅为0．002 D。结论屈光性调节性内斜视儿童戴镜后屈光状态随着年龄的增长，远视度先增加后减少，而后有逐渐正视化趋势：年均改变速度〈0．25 D。

Objective To investigate the effect of age on the development of refractive changes in children with accommodative esotropia after wearing glasses with a follow-up study based on clinical exams and spectacle wear. Methods In this retrospective study, 65 children with accommodative esotropia were examined once every 2-4 months with retinoscopy without cycloplegia for 1-7 consecutive years. A paired t test was used to compare the refractive differences between the dominant eye and non-dominant eye, linear regression curve was used to analyze the data comparing refraction and the timeline of the observation period. Results There was a linear regression between the changes of spherical equivalent refraction, spherical refraction, cylinder refraction and age （P〈0.01）. The spherical equivalent refraction of the dominant eye and non-dominant eye with accommodative esotropia showed a decrease of 0.015 D and 0.012 D per month, respectively. Overall, the change in hyperopic spherical equivalent first increased and then decreased. There was a gradual trend toward myopia. Astigmatism was nearly constant. The change age was 3.58-4.90 year old during the study. The monthly average rate of change in the development of astigmatism was only 0.002 D. Conclusion The development of refractive changes in children with accommodative esotropia after wearing glasses first showed a change in the direction of hyperopia, then in the direction of emmetropization. The average annual rate of change was less than 0.25 D.