角膜塑形镜矫正单眼近视对近立体视功能的影响

The effect of correcting unilateral myopia by Ortho-K contact lens to near stereo vision

目的观察单眼近视患者配戴角膜塑形镜后的近立体视功能。设计回顾性病例系列。研究对象苏州市眼视光医院在2009年10月到2011年12月期间配戴角膜塑形镜的23例单眼近视患者,平均年龄(12.28±2.41)岁(8～17岁)。患眼平均屈光度(-2.71±1.09)D(-1.25^-4.875 D)。方法配戴前检查最佳矫正对数视力,戴框架眼镜矫正后近立体视功能(Titmus立体视图),并于配戴后1周、1个月、3个月进行上述检查。主要指标裸眼视力、最佳矫正视力、屈光度及框架眼镜矫正后近立体视功能。结果配戴前平均裸眼视力4.26±0.23,最佳矫正视力5.02±0.07;配戴后1周、1个月、3个月裸眼视力分别为:4.97±0.07、5.03±0.08、5.05±0.06;配戴后1周裸眼视力较配戴前最佳矫正视力低,差异有统计学意义(P=0.015),配戴后1个月、3个月裸眼视力与配戴前最佳矫正视力比较差异无统计学意义(P=0.257,0.090)。单眼近视程度与近立体视呈负相关,近视度数越高,近立体视功能越差(r2=0.726,P=0.000)。配戴前9例(39%)患者有中心凹立体视;异常立体视者14例(61%),其中8例黄斑立体视,4例周边立体视,2例立体盲。配戴后1周中心凹立体视者10例(43%),与配戴前比较无统计学差异(P=0.500)。配戴1个月后中心凹立体视者13例(57%),与配戴前比较无统计学差异(P=0.188);配戴3个月后中心凹立体视者17例(74%),与配戴前比较有统计学意义(P=0.018)。结论配戴角膜塑形镜后3个月的多数单眼近视患者在提高裸眼视力的同时可获得近立体视。

Objective To observe the recovery of near stereo vision after wearing Ortho-K （OK） contact lens for unilateral myopia. Design Retrospective case series. Participants Twenty three cases of unilateral myopia corrected by Ortho-K contact lens during Octo- ber 2009 and December 2011 in Suzhou Eye Hospital were collected. The average age of participants was 12.28±2.41 years. The refractive error varied from -1.25 D to -4.875 D, on average -2.71±1.09 D. Methods The visual acuity, near stereo vision （Titmus） were checked pre-wearing Ortho-K contact lens, and 1 week, 1 month, 3 months post-wearing respectively. Main Outcome Measures Uncorrected visual acuity （UCVA）, best corrected visual acuity （BCVA）, refraction and near stereo vision with glasses. Results The mean UCVA was 4.26±0.23, and BCVA was 5.02±0.07 pre-wearing OK contact lens. The UCVA was 4.97±0.07, 5.03±0.08, 5.05±0.06 at post-wearing OK lens 1 week, 1 month, 3 months respectively. The UCVA at post-correction 1 week was significantly lower than pre-correction BCVA （P=-0.015）. But at post-correction 1 month and 3 months, the UCVA was no significantly difference with pre-correction BCVA （P=0.257 and 0.090 respectively）. The higher the unilateral myopia was, the poorer the stereo vision was （r2=0.726, P= 0.000）. Before correction, 9 cases （39%） had macular fovea stereo vision. Abnormal stereo vision existed in 14 cases （61%）, including 8 cases with macula stereo vision, 4 cases with peripheral stereo vision, and 2 cases with stereo vision blind. Compared with pre-correction, macular fovea stereo vision was found in 10 cases （43%）, 13 cases （57%） and 17 cases （74%） post-correction 1 week （P=0.50）, 1 month （P=0.19） and 3 months （P=0.018） respectively. Conclusion The study indicates that the severer unilateral myopia is, the poorer stereo vision is. Most unilateral myopia patients can get perfect stereo vision after wearing Ortho-K contact lens 3 months.