综合治疗大龄儿童及青少年屈光参差性重度弱视疗效分析

目的:观察大龄儿童及青少年屈光参差性重度弱视综合性治疗的疗效。方法:将56例56眼9~19岁的屈光参差性重度弱视患者分成两组,两组患者均充分散瞳验光,观察组(A组)配戴高透氧性硬性角膜接触镜(rigid gas permeable contact lens,RGPCL),对照组(B组)给予足矫框架眼镜,两组均进行遮盖、增视治疗、脱抑制治疗,在弱视眼矫正视力>4.7时,除继续遮盖、增视治疗、脱抑制治疗外,增加双眼视觉及立体视觉训练,随访观察24mo。结果:弱视治疗18mo后,两组的总有效率均为100%。比较两组的弱视治疗24mo时临床治愈率、脱抑制率、立体视≤100患者所占百分比。A组临床治愈率为33%,B组为8%,A组的临床治愈率高于B组,两组疗效差异有显著性(χ2=4.02,P<0.05)。A组的脱抑制率为37%,而B组的脱抑制率为4%,两组疗效差异有显著性(χ2=14.43,P<0.05)。A组立体视≤100患者占30%,B组占4%,两组疗效差异有显著性(χ2=4.83,P<0.05)。A组全部患者均能满意接受配戴RGPCL,所有患者均未出现角膜上皮损伤、感染、结膜明显充血、分泌物增多及眼部磨痛、痒、异物感等不适。在配戴过程中未出现镜片护理方面问题。结论:对大龄儿童及青少年屈光参差性重度弱视应采取积极弱视治疗,两组的有效率达到了100%。配戴RGPCL组24mo脱抑制率、临床治愈率、立体视优于戴框架眼镜组。对于屈光参差性弱视,应建议患者戴RGPCL以提高临床治愈率,最大可能地恢复立体视。

Effect of comprehensive treatment for old children and juvenile with serious anisometropia amblyopia

·AIM:To evaluate the effect of comprehensive treatment for old children and juvenile with serious anisometropia amblyopia.·METHODS:Fifty-six old children and juvenile with serious anisometropia amblyopia were divided into two groups.Group A(30 patients)wore rigid gas permeable(RCP)lenses and group B patients wore eyeglass frames.Both groups received same amblyopia therapy with a patch,visual stimulation therapy,antisuppression therapy.Anisometropia amblyopia old children and juvenile were added binocularity therapy and stereopsis therapy while their corrected acuity ≥4.7.The effects of the treatment methods were compared.·RESULTS:The effective rate of both groups with serious anisometropia amblyopia were 100%.After 24 months,group A had cure rate of 33%,while group B only had cure rate of 8%.The cure rate differed significantly between two groups.Antisuppress rate of group A was 37%,antisuppress rate of group B was 4%,The cure rate differed significantly between two groups.The rate of group A which had stereo vision acuity ≤100 was 30%,the rate of group B was 4%.No conditions such as corneal abrasion or conjunctival congestion occurred,and there were none of the problems that occurred with spectacle lenses treatment.·CONCLUSION:The effective rate of both groups with serious anisometropia amblyopia are 100%.After 24 months,group A is better than group B in cure rate,antisuppress rate and stereo vision acuity.The result differed significantly between two groups.·