儿童混合性散光所致弱视的配镜原则和疗效观察

Glasses Principle and Treatment Effect of Amblyopia due to Mixed Astigmatism in Children

探讨儿童混合性散光弱视的配镜原则和临床疗效.选择4-8岁混合性散光弱视儿童161例287眼,用1%阿托品散瞳验光配镜,并配合弱视治疗,连续5年观察屈光状态变化和弱视疗效.随访5年,所有患儿屈光状态呈现出远视等效球镜屈光度逐年减少;近视等效球镜屈光度逐年增加;散光度数及轴位基本不变的趋势.弱视有164（57.14%）只眼进步,102（35.54%）只眼基本痊愈,总有效率为266（92.68%）只眼,无效21（7.32%）只眼.混合性散光弱视的疗效与散光度数呈负相关,与戴镜治疗时间呈正相关.儿童混合性散光的配镜是难点,应根据儿童屈光特点及调节;眼位等情况综合考虑正确配镜,随着年龄增长,混合性散光有向单纯近视散光或复性近视散光发展的趋势,应每半年散瞳验光一次,及时调整镜片度数.同时配合弱视治疗能取得满意的疗效.

To explore glasses principle and treatment effect of amblyopia due to mixed astigmatism in children. 287 eyes of 161 subjects with amblyopia due to mixed astigmatism aged from 4 years to 8 years are enrolled. All cases are given mydriatic optometry by 1% atropine. Meanwhile,the amblyopia treatments are given as well. Follow-up measures include dioptric situation and amblyopia therapeutic effectiveness lasting for 5years. Dioptric situation in all cases present that hyperopia spherical equivalent diopter decreases and myopia spherical equivalent diopter increases yearly. Degree and axis of astigmatism nearly keep unchanging. As to amblyopia,164 eyes（ 57. 14%） have improved,102 eyes（ 35. 54%） have recovered nearly and 21 eyes（ 7. 32%） have no improvement. The total effective rate is 266 cases（ 92. 68%）. The therapeutic effect of amblyopia due to mixed astigmatism has a negative correlation with amblyopia degree and has a positive correlation with time of wearing glasses. The difficulty of children mixed astigmatism is glasses,which should draw up rightly on the synthesizing of children dioptric situation characteristic,accommodation and eye position. Mydriatic optometry should be given every half year to adjust degree of glasses in time,because there is a trend that mixed astigmatism could develop to simple or mixed myopic astigmatism with age. Meanwhile,coordination with amblyopia therapy would provide a satisfying effect.