RGP配戴综合疗法治疗大龄儿童及青少年屈光参差性弱视

Effect of comprehensive treatment for children and teenagers with anisometropia amblyopia

目的:观察RGP配戴联合综合治疗大龄儿童及青少年屈光参差性弱视的临床疗效。方法:选择2007-01/2010-10在我院确诊为屈光参差性弱视并已配戴框架眼镜辅以遮盖等其他方法治疗0.5a无效的8～15岁患者45例,均为单眼,设置RGPCL组(A组)配戴RGPCL22例,同期继续戴框架眼镜治疗的为B组共23例,两组均进行遮盖,红光闪烁,同视机脱抑制,口服左旋多巴及使用增视能双眼视觉和立体视觉综合治疗的方法进行治疗,随访30mo观察患者的视力恢复情况及远近立体视觉情况。结果:综合弱视治疗30mo后,两组病例的矫正视力都有提高,A组基本治愈率为40.9%,B组基本治愈率为17.4%,A组疗效明显高于B组,两组有统计学意义(χ2=6.932,P<0.05);经秩和检验,A组远近立体视明显高于B组(P<0.05)。结论:对大龄儿童及青少年屈光参差性弱视应采取积极的弱视治疗,对于屈光参差性弱视,应建议患者戴RGPCL可以提高临床治愈率,最大可能地恢复立体视。

AIM：To evaluate the effect of comprehensive treatment for children and teenagers with anisometropia amblyopia.METHODS： Forty-five children and teenagers with anisometropia amblyopia, aged 8-15 years old, selected from our hospital between January 2007 and October 2010, were divided into two groups. Group A （22 patients） wore rigid gas permeable（RGP） lenses and group B wore eyeglass frames. Both groups received same amblyopia therapy with a patch, red light flashing, synoptophore disinhibition, and using of oral levodopa and depending on binocular vision and stereopsis comprehensive treatment method to carry on the treatment. Follow-up for 30 months observed in patients with visual acuity and stereopsis of near and far.RESULTS： Comprehensive treatment of amblyopia after 30 months, two cases of corrected visual acuity were improved, Recovery rates were different for groups A and B：40.9%（9/22） and 17.4%（4/21）, the curative effect of group A was significantly higher in B group, two groups had statistical significance（χ2=6.932, P0.05）. The rank sum test, group A of far and near stereopsis was clearly higher than group B（P0.05）.CONCLUSION：Older children and teenagers with anisometropic amblyopia should take active treatment of amblyopia. For anisometropic amblyopia, patients should be recommended to wear RGP lens, which can improve the clinical cure rate,and maximize the possible recovery of binocular vision.