屈光性调节性内斜视远期疗效分析

A long-term clinical study of accommodative esotropia

目的 :观察屈光性调节性内斜视 (refractiveaccom modativeesotropia ,RAET)戴镜后眼位、视力、屈光度及双眼单视功能情况。方法 :回顾性分析RAET 10 4例 ,平均随访 7.5年 ,以末次检查结果为准。结果 :82例眼位良好 ,16例眼位回退 ,6例合并间歇性外斜视。治疗前注视眼平均屈光度(5 .84± 1.93)D ,非注视眼 (6 .6 7± 1.6 5 )D ,治疗后注视眼平均屈光度 (4 .2 2± 2 .2 0 )D ,非注视眼 (5 .2 8± 2 .0 8)D。 183眼合并弱视 ,14 5眼弱视治愈。 80例有融合范围 ,6 8例有立体视。结论 :RAET在长期临床观察中发现 ,多数持续到青春期或成年早期。随着年龄的增长 ,注视眼与非注视眼同时正视化。眼位回退、合并垂直斜视、两眼较大屈光参差、重度弱视影响双眼单视功能的恢复。

Objective:To observe ocular alignment,visual acuity, refractive error and binocular vision after wearing spectacles to correct refractive accommodative esotropia(RAET).Methods:104 patients with RAET were followed an average of 7.5 years retrospectively.Results:82 patients(78.84%) were orthophoric after wearing glasses,16 patients(15.38%) had partially deteriorated RAET and 6 patients had complications with intermittent esotropia. Before treatment the average refraction of the fixating eye was(5.84±1.93)D and the nonfixating eye was(6.67±1.65)D. After treatment the average refraction of the fixating eye was(4.22±2.20)D and the nonfixating eye was(5.21±2.08)D. 183 eyes patients were amblyopic,145 eyes amblyopia were cured. 80 cases had fusional vergence. 68 cases had stereopsis.Conclusion:For most patients,refractive accommdative esotropia persists into adolescence and early adulthood. A few patients had partially deteriorated RAET. The refractive error of the fixating eye and nonfixating eye decreased as age increased. These patients need to be monitored carefully. Deteriorating RAET,high anesometropia,strong amblyopia and complications of vertical strabismus influenced the ability to assess binocular vision.[