睫状肌麻痹状态下不同程度的屈光矫正对远视性弱视儿童眼球正视化过程的影响

Effects of varying degrees of diopter correction on the course of emmetropization of children with hyperopia under children's ciliary muscles paralysis

目的分析在睫状肌麻痹状态不同程度的屈光矫正对远视性弱视儿童眼球正视化过程的影响,促进视觉功能的恢复,更有利于患眼正视化。方法选取屈光不正视儿童120例(169眼)采用阿托品散瞳检影验光,在散瞳状态下配镜,根据球镜度减低不同分为配镜度数不同的Ⅰ、Ⅱ、Ⅲ组,Ⅰ组儿童球镜减验光度数的3/4,Ⅱ组儿童减验光度数的1/2,Ⅲ组儿童减验光度数的2/3;之后每6个月进行散瞳检影验光,观察3年,比较患儿治疗情况。结果Ⅰ组儿童治疗后总有效率为68.85%,Ⅱ组儿童为86.21%,Ⅲ组儿童为84.00%,I组与Ⅱ组差异有统计学意义(P<0.05),Ⅱ组与Ⅲ组差异有统计学意义(P>0.05)。各组患儿远视度数明显减低,其中I组患儿平均每年递减度数明显低于Ⅱ组,其差异有统计学意义(P<0.05);Ⅱ、Ⅲ组平均递减度数差异无统计学意义(P>0.05)。眼轴变化I、Ⅱ组差异无统计学意义(P>0.05),Ⅱ、Ⅲ组差异有统计学意义(P<0.05);其中Ⅰ组治愈时间明显长于Ⅱ组,差异有统计学意义(P<0.05),Ⅱ、Ⅲ组差异无统计学意义(P>0.05)。结论给予不同程度的屈光矫正能够影响患儿治疗效果,对远视性弱视儿童眼球正视化有一定的影响,在睫状肌麻痹状态下能够暴露出完全的真实屈光度进行配镜,保留1/3的远视性光学离焦不仅达到屈光矫正的效果,并且更有利于患眼正视化。

Objective To analyze the effects of varying degrees of diopter correction on the course of emmetropization of children with hyperopia under children＇s ciliary muscles paralysis,promote rehabilitation of visual function and emmetropization of the affected eyes.Methods A total of 120 children（ 169 eyes） with ametropia were selected,atropine was used for mydriasis and optometry,the glasses were prepared in the state of mydriasis. All the children were divided into Ⅰ group（ 3/4）,Ⅱ group（ 1/2）,and Ⅲ group（ 2/3） according to the reduction of spherical power. Mydriasis and optometry were performed every six months. All the children were observed for three years to compare the curative effects in the three groups. Results The total effective rates after treatment in Ⅰ group,Ⅱ group,and Ⅲ group were68. 85%,86. 21%,and 84. 00%,respectively,there was statistically significant difference between Ⅰ group and Ⅱ group（ P〈0.05）,there was statistically significant difference between Ⅱ group and Ⅲ group（ P〈0.05）. The degrees of hyperopia decreased significantly,the average annual reduction degree in Ⅰ group was statistically significantly lower than that in Ⅱ group（ P〈0.05）,while there was no statistically significant difference between Ⅱ group and Ⅲ group（ P〈0.05）. There was no statistically significant difference in the change of axis oculi between Ⅰ group and Ⅱ group（ P〈0.05）,while there was statistically significant difference between Ⅱ group and Ⅲ group（ P〈0.05）. The cure time in Ⅰ group was statistically significantly longer than that in Ⅱ group（ P〈0.05）,while there was no statistically significant difference between Ⅱ group and Ⅲ group（ P〈0.05）. Conclusion Varying degrees of diopter correction can affect treatment effect of children with hyperopia to a certain extent,the true diopter is exposed completely under children＇s ciliary muscles paralysis,then the glasses are prepared,retention of hyperopic defocus optical 1/3 not only reach the refractive effect,but also be beneficial to emmetropisation of the affected eyes.