Comparison of clinical outcome of small-incision lenticule intrastromal keratoplasty and FS-LASIK for correction of moderate and high hyperopia

AIM:To compare the clinical outcome of small-incision lenticule intrastromal keratoplasty(s LIKE)and femtosecond laser-assisted in situ keratomileusis(FS-LASIK)for correction of moderate and high hyperopia.METHODS:A case-controlled clinical study was performed.Twenty right eyes of 20 moderate and high hyperopia patients underwent s LIKE(s LIKE group)and 22 right eyes of 22 moderate and high hyperopia patients underwent FS-LASIK(FS-LASIK group)were enrolled in this study from October 2015 to October 2017.Visual acuity,refractive error,corneal thickness,and keratometry were compared between the groups before and 1 y postoperatively.RESULTS:The postoperative uncorrected near visual acuity(UNVA)and uncorrected distance visual acuity(UDVA)were improved in the two groups.The UNVA reached J1 in 15 eyes(75.0%)in the s LIKE group and 5 eyes(22.7%)in the FS-LASIK group 1 y after surgery(χ2=11.476,P=0.001).The UDVA was equal or better than the preoperative CDVA in 16 eyes(80.0%)in the s LIKE group and 8 eyes(36.4%)in the FS-LASIK group,respectively(X2=8.145,P=0.004).No eyes lost any line of best-corrected visual acuity(BCVA)in either group.The amount of postoperative residual hyperopia in the s LIKE group was significantly less than in the FS-LASIK group(Z=-2.841,P=0.004).The postoperative keratometry and corneal thickness were significantly higher in the s LIKE group than in the FS-LASIK group(t=4.411,10.279,P<0.001).The SRI and SAI of the s LIKE group were significantly higher than that in the FS-LASIK group.There was no statistically significant difference in mean decentration between the two groups.CONCLUSION:s LIKE has better visual and refractive outcome than FS-LASIK for correction of moderate and high hyperopia.

Long-term results of clear lens extraction combined with piggyback intraocular lens implantation to correct high hyperopia

AIM:To assess the refractive outcome of clear lensectomy combined with piggyback intraocular lens implantation in highly hyperopic patients.METHODS:This case review included 19 eyes of 10 patients with high hyperopia and axial length less than 21mm.Intraocular lens power was calculated for emmetropia using the Holladay II formula in 17 eyes,and SRK/T formula in 2 eyes following clear lens extraction and piggyback intraocular lens implantation.Patients were examined periodically over 24 months for visual acuity and spherical equivalent(SE).RESULTS:The mean postoperative SE at 24 months was 0.20±1.39D(range,-3.00 to 2.50D),better than preoperative 9.81±2.62D(range,+6.00 to +14.50D)(P【0.001).Five eyes had SE within±0.5D of emmetropia and 11 eyes within±1.00D at postoperative 24 months.The mean postoperative uncorrected visual acuity(UCVA) at 24 months was 0.60±0.36,significantly improved compared to preoperative 1.39±0.33(P【0.001).The mean best-corrected visual acuity(BCVA) at 24 months was 0.49±0.35,not statistically different compared to preoperative 0.38±0.30(P=0.34).Twelve eyes maintained and 1 gained 1 or more Snellen line of BCVA,4 eyes lost 1 line,and 2 eyes lost 2 lines at 24 postoperative months.Twelve eyes best-corrected near visual acuity (BCNVA) achieved J1 at postoperative 24 months compared to preoperative 7 eyes and the other 7 eyes better than J3.CONCLUSION:Clearlensextractioncombinedpiggyback intraocular lens implantation appears to be an effective procedure to correct high hyperopia but mild overcorrection and intralenticular opacification may require secondary procedure.

Conductive keratoplasty: an approach for the correction of residual hyperopia in post-lasik pseudophakia

Although there are many formulae for the calculation of intraocular lens power in the eyes with previous kerato-refractive surgeries, unexpected refractive bias still exists. Hyperopic bias is particularly disliked because it affects both uncorrected distance and near visual acuity. Surgical treatment of the residual hyperopia for the eyes with both laser in situ keratomileusis and cataract surgery remains to be a big problem. Conductive keratoplasty has been shown to be an effective, safe and predictable method for low and moderate hyperopia in the pseudophakic eyes or in the eyes with kerato-refractive surgeries. However, the efficacy and safety of conductive keratoplasty in the correction of residual hyperopia after both corneal and lens refractive surgeries has not been reported. Herein, we reported the surgical correction with conductive keratoplasty for cases of residual hyperopia with/without astigmatism after previous laser in situ keratomileusis for high myopia and following phacoemulsification combined with posterior intraocular lens implantation for complicated cataract.

Correction of extreme hyperopia: artisan iris-fixated intraocular lens implantation for pseudophakia after clear lens extraction

A 22-year-old patient suffering from both-side extreme hyperopia with amblyopia was corrected with an Artisan iris-fixated intraocular lens (IOL) implantation followed to clear lens extraction (CLE) with posterior chamber (PC)-IOL implantation. The preoperative refraction values were +17.75DS -1.50DC × 168° for the right eye and +17.25DS -0.75DC × 8° for the left eye. The uncorrected visual acuity (UCVA) was 20/200 bilaterally and the spectacle-corrected visual acuity (BSCVA) was 20/50 bilaterally. One year after Artisan iris-fixated IOL implantation, bilateral BSCVA was 20/50 with a refraction of +1.25DS -0.75DC × 13° for the right eye and +1.50DS -1.00DC × 55° for the left eye. The outcomes of an Artisan iris-fixated IOL implantation followed to CLE with PC-IOL implantation were encouraging for the correction of extreme hyperopia. Long term follow-up examinations were necessary for further determination of the efficacy and safety of this combinational procedure.

Relation between preoperative hyperopia and surgical outcome in infantile esotropia

AIM: To evaluate the relation between preoperative hyperopia and surgical outcomes of infantile esotropia in patients younger than 24 months of age.METHODS: Medical records of patients who underwent bilateral medial rectus muscle recession for infantile esotropia between November 1, 2002 and December 1, 2011 were retrospectively reviewed. Patients were divided into two groups according to the degree of preoperative hyperopia. Group I had less than +3.0 diopter(D) of hyperopia and group II had between +3.0 and +5.0 D of hyperopia. Postoperative alignments were evaluated 1 wk, 3, 6 mo, and 1 y after surgery. Following the 1-year postoperative visit, patients were monitored yearly. Relationships between preoperative factors including hyperopia and postoperative outcomes were evaluated. RESULTS: Forty-six patients were included, with 33 patients in group I and 13 patients in group II. The preoperative mean refractive error was +0.88 D in group I and +3.45 D in group II. Surgical outcomes were not significantly different between groups at any postoperative time point examined. Cumulative probability of surgical success, prevalence of inferior oblique overaction, dissociated vertical deviation, and re-operation rate were not significantly different between groups.CONCLUSION: Preoperative moderate hyperopia(less than +5.0 D) did not affect the surgical outcome of infantile esotropia. Therefore, the surgical correction of esotropia should be considered when the angle of esodeviation is unchanged following hyperopia correction, even in children with moderate hyperopia.

ONE YEAR RESULTS OF LASER IN SITU KERATOMILEUSIS FOR CORRECTION OF HYPEROPIA

Objective: To evaluate the effectiveness, predictability and city of laser in situ keratomileusis (LASIK) for correction of hyperopia. Methods 54 eyes of 35 patients with hyperopia ranging from+1.00 to + 6. 00 diopter(D) received a one-pass, multizone scanning excimer laser ablations using the Chiron Technolas Keracor 11 7C excimer laser and System ALK automated corneal shaper H-230.Data on uncorrected and hot corrected visual acuity, predictability, stability of refraction, and complications were analyzed. The average follow-up was 12 months. Results At 12 months, the average residual refraction was(+ 0. 29 ±0. 78)D. 45 eyes (83.3% ) were in the range of ±1. OD and 33 eyes(61. 1% ) were within the range of ± 0. 5D. 50 eyes (92. 6% ) had uncorrected visual acuity of 20/40 or better and 34 eyes (63. 0% ) had 20/20 or better. 1 eyes (1. 9% ) lost 2 line of the best-corrected visual acuity and 2 eyes (3. 7% ) gained 2 lines or more. 2 eyes (3. 7%) had complaint of halos and 1 eyes (1. 9% ) had glare at 12 months. Conclusion LASIK can he used to treat hyperopia from + 1. 0D to + 6. 0D with good predictability and city. Primary and second hyperopia should he treated with different nomogram. some modification of the surgical algorithms and laser nomogram will help to improve predictability and stability of outcome.

Management of Exotropia Associated with Hyperopia in Children

Introduction: exotropia is a deviation outside the visual axes. In children, an association with ametropia is often observed, however, that with hyperopia is rare. The objective of this study was to highlight the particularities of the management of exotropia associated with hyperopia in children. Subjects and Methods: this was a retrospective study over 78 months including all children aged 0 to 15 years, treated for exotropia associated with hyperopia. Results: we found 20 cases of exotropia with hyperopia, or 57.15% of exotropia. The mean age was 4.3 years and the sex ratio was 0.82. Hyperopia was mild in 30 eyes (75%), moderate in 9 eyes (22.5%) and high in 2.5% of eyes. Over a one-year follow-up, 10 children (50%) had regular follow-up, including 6 with full hyperopic correction and 4 with partial hyperopic correction. After full hyperopic correction, one child had a resolution of his exotropia;2 had a decrease in the angle of deviation and 3 had no improvement of their exotropia. Among the 4 with partial hyperopic correction children, 2 had a resolution of their exotropia. Strabismus surgery was planned in 3 children after iso-acuity. Conclusion: the association of exotropia and hyperopia poses a management problem. The total correction or not of hyperopia is discussed according to several authors.

Prevalence of refractive errors in school-aged and preadolescent children in Colombia

AIM:To describe the distribution of refractive errors by age and sex among schoolchildren in Soacha,Colombia.METHODS:This was an observational cross-sectional study conducted in five urban public schools in the municipality of Soacha.A total of 1161 school-aged and pre-adolescent children,aged 5-12y were examined during the school year 2021-2022.Examinations included visual acuity and static refraction.Spherical equivalent(SE)was analysed as follows:myopia SE≤-0.50 D and uncorrected visual acuity of 20/25 or worse;high myopia SE≤-6.00 D;hyperopia SE≥+1.00 D(≥7y)or SE≥+2.00 D(5-6y);significant hyperopia SE≥+3.00 D.Astigmatism was defined as a cylinder in at least one eye≥1.00 D(≥7y)or≥1.75 D(5-6y).If at least one eye was ametropic,children were classified according to the refractive error found.RESULTS:Of the 1139 schoolchildren included,50.6%were male,58.8%were aged between 5 and 9y,and 12.1%were already using optical correction.The most common refractive error was astigmatism(31.1%),followed by myopia(20.8%)and hyperopia(13.1%).There was no significant relationship between refractive error and sex.There was a significant increase in astigmatism(P<0.001)and myopia(P<0.0001)with age.CONCLUSION:Astigmatism is the most common refractive error in children in an urban area of Colombia.Emmetropia decreased and myopia increased with age.

Prevalence and Factors Associated with Refractive Errors among University Students at Mbarara University of Science and Technology, Uganda

Introduction: WHO estimated that uncorrected refractive errors are the leading cause of visual impairment and second leading cause of blindness globally. University students are prone to developing refractive errors due to their curriculum that requires a lot of near work affecting their performance and quality of life unknowingly. Genetic and environmental factors are thought to play a role in the development of refractive errors. This study addresses the paucity of knowledge about refractive errors among university students in East Africa, providing a foundation for further research. Objectives: To determine the prevalence and factors associated with refractive errors among students in the Faculty of Medicine at Mbarara University of Science and Technology. Methodology: This was a cross-sectional descriptive and analytical study in which 368 undergraduate students selected using random sampling were assessed for refractive errors from March 2021-July 2021. Eligible participants were recruited and their VA assessment done after answering a questionnaire. Students whose VA improved on pin hole had subjective retinoscopy and results were compiled and imported to STATA 14 for analysis. Results: The prevalence of refractive errors was 26.36% with (95% CI) among university students especially myopia. Myopia is most predominant at 60%, followed by 37% Astigmatism and hyperopia of 3% among medical students. Astigmatism consisted of largely myopic astigmatism 72% (26) and 28% (10) compound/mixed astigmatism only. Student positive family history of refractive error was found to have a statistically significant relationship with refractive errors with AOR 1.68 (1.04 - 2.72) (95% CI) and P (0.032). Conclusion: The prevalence of refractive errors among university students, especially myopia, was found to be high and family history was associated with students having refractive errors.

The Research on the Paths of Popular Science Education about Myopia Prevention and Control among College Students in the Context of Shifting the Focus Forward

Currently, the number of myopic people in China has reached as high as 600 million, and it shows a trend of “early onset, high incidence, and a high degree of severity”. The issue of myopia among children and adolescents has attracted widespread attention from all sectors of society. Comprehensive myopia prevention and control efforts have been launched nationwide. Popular science education, vision screening, and improving visual environments are effective measures for preventing myopia. However, among the target audience for comprehensive myopia prevention and control, the preschool children group has been neglected, and the work of myopia prevention and control for this group has been significantly weakened and marginalized. Due to insufficient awareness of prevention and control, the hyperopia reserve in the preschool children group is being continuously depleted, leading to the early onset of myopia. In light of this situation, the focus of myopia prevention and control needs to shift forward, and it is worth exploring and pondering how college students with a background in optometry can develop entertaining and engaging popular science education materials and methods.

山东某县3~6岁儿童筛查视力异常情况研究

目的描述研究地区3~6岁儿童筛查视力异常情况,为儿童眼病防治及视力异常防控提供参考依据。方法依托山东某县2021年视力筛查项目,所用数据包括儿童基本信息、幼儿园特征及视力筛查结果,分析指标包括裸眼远视力不良率、近视率和可疑远视储备量不足率。采用频数和百分比描述筛查视力异常情况,采用趋势卡方检验分析视力异常指标随年龄变化趋势。结果研究纳入3~6岁儿童14198人,裸眼远视力不良率为19.6%,近视率3.1%,可疑远视储备量不足率42.5%。3岁至6岁,裸眼远视力不良率依次为9.4%、16.4%、24.5%和22.8%,近视率依次为1.9%、1.3%、3.6%和9.0%,两者随年龄增长均呈上升趋势(P<0.05);可疑远视储备量不足率依次为54.6%、42.3%、39.2%和46.0%,随年龄增长未见上升趋势。男童和女童三项指标差别均不超过2.0个百分点;乡镇幼儿园儿童视力不良率比城区幼儿园儿童高8.9个百分点、近视率高5.3个百分点、可疑远视储备量不足率高9.6个百分点;城区私立幼儿园儿童视力不良率比公立幼儿园儿童高9.1个百分点,可疑远视储备量不足率高17.3个百分点,而乡镇私立幼儿园儿童近视率比公立幼儿园儿童低2.4个百分点,可疑远视储备量不足率低8.0个百分点。结论研究地区3~6岁儿童裸眼远视力不良率接近20%,近视率略高于3%,可疑远视储备量不足率超过40%。裸眼远视力不良率和近视率随年龄增长均呈上升趋势,但未见可疑远视储备量不足率随年龄增长呈上升趋势。城乡儿童视力异常情况差别明显,宜探索原因以提升防控针对性。

江阴市学龄前儿童屈光状态调查

目的:了解江阴市学龄前儿童屈光不正现状,为学龄前儿童视力健康防护工作提供指导。方法:选取2023年9—12月江阴全市范围幼儿园内41511名学龄前(3~6岁)儿童作为研究对象,均进行屈光筛查,统计学龄前儿童屈光状态。结果:41511名学龄前儿童中,近视、远视、散光、屈光参差分别检出663人、2023人、10984人、900人,检出率分别为1.60%、4.87%、26.46%、2.17%。不同性别学龄前儿童近视、散光以及屈光参差检出率比较,差异无统计学意义(P>0.05);女童远视检出率高于男童(P<0.05)。不同年龄学龄前儿童近视、散光以及屈光参差检出率比较,总体有统计学差异(P<0.05);不同年龄学龄前儿童远视检出率比较,差异无统计学意义(P>0.05);其中,5岁儿童各类型屈光不正检出率最高。结论:江阴市学龄前儿童散光检出率最高,其次分别为远视、屈光参差、近视,女童远视检出率高于男童,5岁儿童各类型屈光不正检出率最高。卫生部门应加强江阴市学龄前儿童屈光状态筛查工作,及时发现学龄前儿童视力变化及屈光不正状态,加强眼保健的宣教,尽早进行干预,提高学龄前儿童的视力健康水平。

SMILE来源的角膜基质透镜临床再利用的研究进展

随着飞秒激光小切口角膜基质透镜取出术(SMILE)的普及,术中大量一片式角膜基质透镜被取出。角膜基质透镜作为手术的额外产物,对其进行基础研究及临床再利用已成为近年来的研究热点。角膜基质透镜薄而透明,来源丰富,成本低廉,具有低免疫源性及良好的组织相容性等优点,是研究细胞和角膜基质的重要来源,也可作为临床上角膜加固、补片移植、屈光矫正及泪道栓塞的良好生物材料。文章就SMILE手术来源的角膜基质透镜在治疗角膜相关疾病,矫治远视及老视,覆盖青光眼引流阀防止其暴露及用于泪道栓等方面的应用进行综述,旨在充分认识其在临床上的再利用,扩大其手术应用范围,为其他眼病的治疗及组织器官中的应用提供新方向。

准分子激光原位角膜磨镶术矫治儿童单纯远视性屈光参差

目的评价准分子激光原位角膜磨镶术(LASIK)矫治儿童单纯远视性屈光参差的临床疗效。方法采用Summit公司的SVSApexplus准分子激光系统,对22例远视儿童患者(7~15岁)绝对散光值低于1.25D的22只眼进行LASIK手术,最大预矫值+6.00D。术后1个月开始行弱视治疗。随访时间12个月以上。结果术前,球镜屈光度:+5.50^+9.00(+6.25±0.43)D,柱镜屈光度:0.00^-1.25(-0.73±0.33)D,两眼等值球镜屈光度差值:+4.25~7.75(+6.13±0.51)D,裸眼远视力:0.05~0.3(0.12±0.10)D,裸眼近视力:0.1~0.5(0.19±0.14)D,矫正远视力:0.05~0.4(0.20±0.13)D,矫正近视力:0.1~0.6(0.27±0.16)D。术后12月,球镜屈光度:-0.50^+0.75(+1·02±0.51)D,柱镜屈光度:0.00^-1.75(-0.52±0.51)D,两眼等值球镜屈光度差值:0.00~1.75(0.86±0.55)D,平均裸眼远视力:0.1~0.5(0.25±0.13)D,平均裸眼近视力:0.1~1.2(0.53±0.38)D,平均矫正远视力:0.1~0.6(0.29±0·17)D,平均矫正近视力:0.1~1.2(0.56±0.37)D。所有手术眼均未见最佳矫正视力丢失。结论LASIK矫治儿童单纯远视性屈光参差是安全、有效的,可明显减少双眼屈光参差度。术后辅以弱视治疗疗效显著。

自体角膜基质透镜植入术矫治远视的临床应用

背景准分子激光角膜原位磨镶术（LASIK）矫治远视的安全性、有效性和可预测性引起临床医师的广泛关注，但其矫治效果并不如矫治近视者满意。目的观察自体角膜基质透镜植入术矫治远视的安全性、有效性及可预测性。方法对1例右眼为近视状态、左眼为远视状态的女性患者行左眼自体角膜基质透镜植入术，术后随访1个月，应用气动眼压计观察术眼眼压改变，采用角膜地形图检查并评价术眼手术前后角膜曲率的变化，采用光学相干断层扫描仪（OCT）测量手术前后角膜瓣厚度变化；应用眼反应仪测量角膜生物力学（角膜滞后量、角膜阻力因素）的改变；于术前和术后1d、1周、1个月记录患者的裸眼视力、最佳矫正视力和屈光度。结果术眼手术过程顺利，术中、术后未发生并发症。术后1d及1个月术眼裸眼远视力较术前提高1行，裸眼近视力达J2并稳定，术后1个月等效球镜度（SE）为-0．125D。术后1个月OCT检查显示角膜透明，角膜基质囊袋内植片居中在位，无排异反应。术眼术前角膜补偿眼压为12．4mmHg（1mmHg=0．133kPa），术后1个月为11．9mmHg；术前模拟Goldmann眼压为11．9mmHg，术后为10．7mmHg；左眼术前角膜滞后量为9．7mmHg，术后为8．9mmHg；术前角膜阻力因素为10．9mmHg，术后为10．3mmHg，角膜生物力学各参数均无明显改变。结论自体角膜基质透镜植入术矫治远视安全、有效，可预测性好，手术前后眼压和角膜生物力学无明显改变，为远视的矫治提供了新的选择。

准分子激光原位角膜磨镶术矫治儿童远视性屈光参差的临床观察

目的 评价准分子激光原位角膜磨镶术(laserinsitukeratomileusis ,LASIK)矫治儿童远视性屈光参差的临床疗效。方法 采用Summit公司的SVSApexplus准分子激光系统,对45例(4 6眼)绝对散光值低于1.2 5D的远视儿童患者(7～14岁)进行LASIK手术。随访时间:6～3 6个月。结果 术前,平均等值球镜屈光度:+ 4 77D(+ 3 5 0～+ 6 75D) ,两眼等值球镜屈光度差值:+ 4 3 9D(+ 3 2 5～+ 6 75D) ,平均裸眼远视力:0 12 (0 0 4～0 3 ) ,平均裸眼近视力:0 2 3 (0 0 5～0 8) ,平均最佳矫正远视力:0 2 3 (0 0 5～1 0 ) ,平均最佳矫正近视力:0 41(0 0 5～1 2 )。术后12个月,平均等值球镜屈光度:+ 0 47D(+ 0 0 0～+ 1 2 5D) ,两眼等值球镜屈光度差值:+ 0 2 7D(+ 0 0 0～+ 1 0 0D) ,平均裸眼远视力:0 48(0 1～1 0 ) ,平均裸眼近视力:0 78(0 4～1 5 ) ,平均最佳矫正远视力:0 66(0 4～1 2 ) ,平均最佳矫正近视力:0 91(0 5～1 5 )。所有手术眼均未见最佳矫正视力丢失。结论 LASIK矫治儿童单纯远视性屈光参差是安全、有效的,可明显减少双眼屈光参差度。术后辅以弱视治疗疗效显著。

青少年黄斑中心凹下脉络膜厚度与屈光度的关联性分析

背景 脉络膜厚度与屈光不正有一定的联系,研究两者之间的关系对于屈光不正发病机制的研究有重要意义. 目的 探讨黄斑中心凹下脉络膜厚度（SFCT）与屈光度的关联性.方法 采用回顾性系列病例观察研究.收集2012年6-8月在中山大学中山眼科中心就诊的屈光参差患者40例,按年龄分为6 ～13岁组和14 ～21岁组.巩膜在13岁基本发育完全,巩膜的发育对脉络膜厚度有较大的关联,因此分2组观察不同年龄段的脉络膜厚度与屈光度的关系.常规用EDTRS视力表进行视力测量、裂隙灯显微镜及直接检眼镜检查后,快速扩瞳,再进行主观验光、客观验光.应用EDI SD-OCT测量SFCT,在EDI模式下于眼底后极部进行图像采集.应用Lenstar 900型眼轴测量仪进行眼轴长度测量.采用成组设计t检验对不同性质屈光状态下SFCT的差异进行比较,采用Pearson直线相关分析和线性回归法分析SFCT与屈光度的关系. 结果 所有患者的SFCT均值为（307.82±88.47） μm,近视眼平均SFCT为（270.60±70.57） μm,明显低于远视眼的（376.95±76.59） μm,近视眼与远视眼间SFCT的差异有统计学意义（t=6.240,P=0.000）.在6～13岁组,SFCT与屈光度间的回归系数为18.60,回归方程为Y=18.60X ＋310.79（r=0.345,F=21.110,P=0.000）;SFCT与眼轴长度之间的回归系数为-31.76,回归方程Y=-31.76X＋1 039.97（r=0.262,F =17.320,P=0.000）.14 ～21岁组,SFCT与屈光度之间的回归系数为23.38,回归方程Y=23.38X＋353.17（r=0.430,F=27.210,P=0.000）;SFCT与眼轴长度之间的回归系数为-35.82,回归方程为Y=-35.82X＋1 132.75（r=0.237,F=15.650,P=0.000）.结论 SFCT与屈光度呈正相关,屈光度越偏向正值,SFCT值越大;而屈光度向负值增加-1D,SFCT则减少约20 μm.眼轴越长,SFCT值越下降.

远视性屈光不正儿童屈光状态远期变化

探讨远视性屈光不正儿童屈光状态远期变化规律。方法 :对 16 2例 (32 4只眼 ) 3～ 12岁远视性屈光不正儿童进行 5～ 12 .5年的观察 ,分别按性别、眼别、子午线、远视程度及不同年龄阶段进行分级 ,计算各组的年均下降远视屈光度 ,用u检验和方差分析。结果 :男女两组年均下降屈光度分别为 0 .34± 0 .17D和 0 .35±0 .17D ,左右眼为 0 .35± 0 .17D、0 .33± 0 .16D ,平均 90°和 180°子午线轴为 0 .35± 0 .16D、0 .36± 0 .17D ,无显著性差异 ;轻、中、高度远视为 0 .45± 0 .19D、0 .2 7± 0 .16D、0 .36± 0 .17D ,中度远视下降最慢 ,轻、高度远视差异无显著性 ;<6岁 ,6～ 9岁和≥ 9岁三组分别为 0 .46± 0 .15、0 .37± 0 .2 0D、0 .15± 0 .0 6D ,有显著性差异。结论 :远视性屈光不正儿童的屈光随年龄的增长逐年下降 ,9岁以后趋于稳定 ,但散光无明显改变 ;远视下降速度以中度远视最慢 ,高度和轻度远视下降较快 ,后者易发展为近视眼。下降速度与性别、眼别无关。

上海市区学龄前儿童屈光异常852例分析

目的:了解上海市区部分学龄前儿童屈光的异常状态及视力矫正情况。方法:视力异常学龄前儿童852例(1615眼)作散瞳验光检查,并对检查结果进行分析探讨。结果:单纯近视443眼(27.43%),复性近视散光255眼(15.79%),单纯远视287眼(17.77%),复性远视散光347眼(21.49%),混合性散光283眼(17.52%)。随着年龄的增长,就诊的学龄前近视患者逐渐增多;父母近视对学龄前儿童近视发生率的增加有影响;屈光不正大都以轻中度为主(82.43%),视力大多(80.40%)是可以矫正的。结论:学龄前儿童近视和近视散光的发生率有明显增加的趋势。

角膜屈光手术对成人和青少年远视性屈光参差性弱视的临床意义

目的:研究准分子激光角膜屈光手术治疗成人或大龄的青少年远视性屈光参差性弱视的疗效。方法:选取2010-09/2013-03在我院行准分子激光角膜屈光手术的伴有弱视的远视性屈光参差患者共11例16眼,年龄15岁以上,随访6mo以上。记录患者术前术后裸眼视力、最佳矫正视力、睫状肌麻痹后屈光度以及立体视等情况,并询问患者主觉视觉质量改善的状况以及对手术的满意度。结果:手术眼16只平均睫状肌麻痹后屈光度的等效球镜从术前的5.76±1.71D降到术后1.42±1.22D(t=13.6,P=0.00)。11例患者双眼间屈光参差从术前的3.78±2.39D降到手术后1.14±1.50D(t=6.08.P=0.00)。手术后患者看远裸眼视力从0.35±0.27上升到0.45±0.29(t=-4.76,P<0.001),看近裸眼视力从0.26±0.24上升至0.49±0.27(t=5.43,P=0.00);术前worth四孔灯检查4例显示弱视眼抑制。手术后均恢复了正常。同视机检查6例有立体视,术后为10例。Titmus立体视检查立体视锐度也明显提升(t=-2.97,P=0.003)。没有术中、术后明显并发症发生。所有患者主诉生活中视觉质量明显改善并对手术效果感到满意。结论:准分子激光角膜屈光手术是治疗过了视觉敏感期的成人或大龄青少年远视性屈光参差性弱视,尽管对弱视眼视力提升有限,但依然提高患者的裸眼视力和立体视功能,改善患者生活质量,是一种值得采用的方法。