双眼视功能训练在准分子激光治疗屈光参差性近视后的应用研究

Application of Binocular Vision Function Training in the Treatment of Anisometropic Myopia after Excimer Laser Treatment

目的对屈光参差性近视患者进行准分子激光治疗后进行双眼视功能训练观察其临床效果。方法选取2016年1月—2017年1月于该院进行治疗的30例屈光参差性近视患者为该次研究的实验对象,患眼数共计56眼,使用激光机进行准分子激光手术治疗屈光参差。手术结束后对患者进行跟踪随访12～24个月,随访期间定期检查患者视功能恢复情况,并进行双眼视功能训练,比较手术前、后和双眼视功能训练结束后的裸眼视力,最佳矫正视力以及双眼视功能。结果相较于接受修复手术前,术后1周30例患者的裸眼视力均明显改善,但两眼屈光度不同的两眼裸眼视力相差较大,其中裸眼视力相差两行以上的患者有21例,相差1行的患者有5例。接受双眼视功能训练后,所有患者的裸眼视力差距得到改善,其中相差2行以上者有2例,相差1行者有3例,相较训练前有明显提高(P<0.05)。从双眼视功能情况进行比较,手术后同时视、融合、远立体视正常者较手术前均有提高,接受双眼视功能训练后,上述情况进一步改善,30例患者同时视和融合功能正常,24例患者远立体视功能正常,与训练前差异有统计学意义(P<0.05)。结论双眼视功能功能训练对于接受准分子激光治疗的屈光参差性近视患者有重要意义,不仅在功能上能够使患者症状得到改善,提高患者裸眼视力,促进视功能的进一步恢复等,在心理上也能够使患者更加重视对眼睛的保护,进一步巩固手术治疗的效果,值得临床进一步推广。

Objective To observe the clinical effects of binocular vision training after excimer laser treatment in patients with anisometropic myopia. Methods Thirty patients with anisometropic myopia who were treated in our hospital from January 2016 to January 2017 were enrolled in this study. The total number of eyes was 56. The laser was used for excimer laser surgery. The light is staggered. After the operation, the patients were followed up for 12 to 24 months.During the follow-up period, the visual function recovery of the patients was regularly checked, and the binocular visual function training was performed to compare the naked eye vision before and after the operation, and the best correction vision and binocular vision. Results Compared with the surgery before the operation, the visual acuity of the naked eyes was significantly improved in 30 patients at 1 week after surgery, but the visual acuity of the two eyes with different diopter was different, and 21 patients with two or more glasses with poor visual acuity. There were 5 patients with a difference of 1 line. After receiving binocular vision training, the visual acuity difference of all patients was improved.Among them, 2 patients had a difference of 2 or more, and 3 patients had a difference of 1 row, which was significantly higher than that before training(P<0.05). Comparing the binocular visual function, the patients with normal vision, fusion and far stereopsis were improved compared with those before surgery. After receiving binocular visual function training, the above situation was further improved, and 30 patients had normal vision and fusion function. The 24 patient’s far stereoscopic function was normal, and the difference was statistically significant(P<0.05). Conclusion The binocular visual function training is of great significance for patients with anisometropic myopia who are treated with excimer laser. It not only can improve the patient’s symptoms, improve the naked eye vision, and promote the further recovery of visual function. It can also make patients pay more attention to the protection of the eyes and further consolidate the effect of surgical treatment, which is worth further clinical promotion.