欠矫和足矫对高度远视屈光不正性弱视患儿的疗效分析

Analysis on efficacy of under correction and full correction on children with high hyperopia and amblyopia

目的:探讨欠矫正与足矫正是否影响高度远视屈光不正性弱视患儿屈光度的变化和视力的提升。方法:回顾性病例研究。收集2015-01/2019-12在遂宁市中心医院行弱视治疗满3a及以上的高度远视屈光不正性弱视患儿49例98眼。根据患儿配镜处方与睫状肌麻痹验光结果的差别分欠矫正组29例58眼(球镜度数相差≥1.5D)和足矫正组20例40眼(球镜度数相差≤0.25D)。分析两组患儿3a治疗过程中矫正视力和屈光度的变化。结果:初诊时两组患儿的年龄、屈光度和矫正视力均无差异(P>0.05)。矫治过程中两组患儿的屈光度均逐渐降低,且欠矫正组患儿屈光度下降幅度高于足矫正组(F时间=500.299,P时间<0.01;F组间=6.949,P组间=0.010)。治疗过程中欠矫正组患儿总的屈光度下降1.215±0.262D,高于足矫正组0.612±0.211D(t=-12.068,P<0.01)。两组患儿的矫正视力都随治疗时间的延长而改善,欠矫正组患儿视力改善优于足矫正组(F时间=1138.526,P时间<0.01;F组间=14.206,P组间<0.01)。结论:远视欠矫正患儿屈光度下降和视力提升优于足矫正,适当的远视欠矫正能更好地促进高度远视屈光不正性弱视患儿眼球的生长和视力提升。

AIM:To investigate whether under-correction and full correction affect the refractive changes and vision improvement of children with high hyperopia and amblyopia.METHODS:A total of 49 children(98 eyes)with high hyperopia and amblyopia who received amblyopia treatment for 3a or more in Suining Central Hospital from 2015 to 2019 were collected.According to the differences between the prescription of optician and the results of cycloplegic refractions,the patients were divided into two groups:under correction group 29 cases with 58 eyes(the difference of spherical power≥1.5D)and full correction group 20 cases with 40 eyes(the difference of spherical power≤0.25D).Then,repeated measurement analysis of variance method was used to analyze the changes of refractive error and vision of the two groups of children during 3a of treatment.RESULTS:There was no statistical difference in age,diopter and corrected vision between the two groups at the beginning of diagnosis(P>0.05).The diopter of the two groups decreased gradually during the treatment,and the diopter of the children in the under correction group decreased significantly higher than that in the full correction group(Ftime=500.299,Ptime<0.01,Fgroup=6.949,Pgroup=0.010).The reduction of hyperopia in the under correction group was 1.215±0.262D,and 0.612±0.211D in the full correction group.The hyperopia reduction was significantly higher in the under correction group(t=-12.068,P<0.01).The corrected visual acuity of the two groups increased with the prolongation of treatment time.The improvement of visual acuity in the under correction group was significantly better than that in the full correction group(Ftime=1138.526,Ptime<0.01,Fgroup=14.206,Pgroup<0.01).CONCLUSION:The hyperopia reduction and vision improvement of children with under correction were better than that with full correction.Suitably under correction of hyperopia can better promote the eye growth and vision improvement of children with high hyperopia and amblyopia.