58例屈光性调节性内斜视的综合治疗分析

目的 探讨屈光性调节性内斜视的综合治疗方法.方法 总结分析58例调节性内斜视的治疗情况,分析评定疗效.结果所有病例恢复正常眼位,恢复双眼单视功能.结论调节性内斜视的治疗是一个综合治疗过程,双眼视力基本平衡时可手术干预残余斜视角.强调双眼单视功能的检查和训练.     

调节性内斜视的治疗

目的探讨与调节有关的内斜视矫正规律.方法随机选择56例有调节性因素的内斜视进行散瞳检影、戴镜和综合弱视治疗,首次、治疗后6个月、12个月和24个月检影验光1次,检查内斜矫正度.结果治疗6月后内斜度数基本稳定.结论与调节性有关的内斜视戴镜治疗6个月后,即可考虑手术矫正非调节部分内斜视.     

屈光性调节性内斜视的综合治疗临床分析

目的　探讨屈光性调节性内斜视的综合治疗方法 ,总结临床经验。方法　随机收集 70例屈光性调节性内斜视 ,进行临床回顾性分析 ,分析评定疗效。结果　所有病例恢复正常眼位 ,恢复双眼单视功能。结论　屈光性调节性内斜视的治疗是一个综合治疗过程。强调双眼单视功能的检查 ,评定及功能训练     

改良内斜视矫正术治疗部分调节性内斜视

目的探讨部分调节性内斜视手术的临床效果。方法对52例部分调节性内斜视以[(裸眼视近-裸眼视远)+(戴镜视近-戴镜视远)]×1/2之所得三棱镜度设计行内斜矫正术,术后平均观察2年。结果术后2年,斜视治愈率高达94.23%;术后矫正视力较术前均有不同程度提高,差异有统计学意义,P<0.05;双眼单视功能较术前均有明显改善,差异有显著性,P<0.05。结论以1/2×[(裸眼视近-裸眼视远)+(戴镜视近-戴镜视远)]的斜视角来设计手术,对矫正部分调节性内斜视效果较好,但要注意早诊断早治疗。     

完全调节性内斜视远期疗效观察

完全调节性内斜视是由于过度调节而引起的调节性集合过量所产生的内斜眼位，此种斜视当远视全部矫正后，内斜完全消失。本文11例完全调节性内斜视经全矫配镜后，斜度完全消失。在同时采用压抑疗法治疗过程中，观察眼位能否长期维持正位，屈光度和视力及双眼视功能的改善状况。随访sa以上，现报告如下。区临床资料本组共11例，男5例，女6例；右眼4例，左眼7例。就诊年龄4～15a，随访时间为5～9．25。。全部病历经门诊常规检查后用109·kg－‘阿托品膏散瞳7d，用带状光检影镜视网膜检影法验光。全部的。均为远视和复性远视散光，屈光度均在一…     

非手术治疗部分调节性内斜视

目的探讨儿童部分调节性内斜视非手术治疗的可行性。方法对56例儿童部分调节性内斜视患者进行散瞳验光配镜，弱视训练，遮盖非斜位眼。结果56例完全功能治愈41例占74％，好转12例，占21％，无效3例占5％。结论儿童部分调节性内斜视非手术治疗是可行的有效的，且越早矫治效果越好。     

屈光性调节性内斜视的临床观察

目的探讨屈光性调节性内斜视的临床特点、弱视治疗结果及屈光状态的最后转归。方法追踪观察287例屈光性调节性内斜视,对年龄、弱视程度、屈光度数对疗效的影响进行了统计分析。结果此病的眼位恢复一次正位率83.62%;远、近视功能均恢复者占57.14%;弱视的总治愈率为75.18%;屈光度大于或等于8.00DS时,治愈率为45.63%;重度弱视治愈率27.69%;年龄小于或等于3岁时治愈率91.57%,大于或等于8岁时治愈率56.92%;在屈光性调节性内斜视患者中,67.61%的屈光度大于6.00DS。结论屈光性调节性内斜视患者应尽量早发现、早治疗,坚持长期配戴眼镜,可以获得较好的临床效果。     

调节性内斜视的治疗

目的 探讨调节性内斜视的综合治疗方法.方法 总结分析87例调节性内斜视的治疗情况,所有病例经1%阿托品扩瞳验光后戴镜矫正,弱视眼进行综合训练.戴镜半年后对眼位戴镜不能矫正且双眼视力基本平衡的患儿通过手术干预矫正眼位.结果 经戴镜眼位恢复正位69例(79.31%).戴镜并同时进行弱视训练半年后18例斜视角无法全部矫正的患儿采用手术方法矫正眼位.术后进行双眼单视训练.所有病例恢复正常眼位及双眼单视功能.结论 调节性内斜视的治疗是一个综合性的治疗过程,双眼视力基本平衡时可手术干预残余斜视角.强调双眼单视功能的检查和训练.(中国眼耳鼻喉科杂志,2009,9:33-34)     

部分调节性内斜视手术治疗分析

部分调节性内斜视手术治疗分析山西省眼科医院申长礼，张素华，刘志平部分调节性内斜视即屈光性调节性内斜戴完全矫正的眼镜仍残留一部分内斜或非屈光调节性内斜注视远距离物体时即有内斜，故又称为混合型内斜。常见于１１岁以下儿童。现将我院眼肌组近几年来３０例部分调...     

屈光性调节性内斜视的临床观察

目的总结屈光性调节性内斜视(RAET)的临床特点,探讨RAET的有效治疗方法。方法随机收集65例,随访观察3年以上的RAET的临床资料,进行回顾性分析。结果全部病例均在戴镜后恢复正常眼位及双眼单视功能,5例发生眼位回退。结论RAET的治疗是一个全面综合的治疗过程,对斜视度、屈光度、视力、双眼单视功能等多项指标进行定期检查评估,以保证RAET治疗效果。     

屈光性调节性内斜视临床观察

目的探讨屈光性调节性内斜视的临床特点,弱视治疗结果及屈光度变化。方法 219例屈光性调节性内斜视患者,观察其眼位、立体视以及初次戴镜年龄、屈光度、弱视程度对弱视疗效的影响,并进行分析。结果 219例患者中,戴镜前仅7例Titmus3000″,弱视213例,216例在配戴全矫眼镜后内斜视消失,经过戴镜及综合弱视训练,弱视基本治愈180例,进步26例,7例无效,基本治愈率88.97%。Titmus<800″216例。结论屈光性调节性内斜视要早发现早治疗,坚持长期配戴矫正眼镜,综合治疗弱视,可获得良好的临床效果。     

Diagnosis and management of accommodative esotropia

Background: Accommodative esotropia is the most common form of childhood strabismus presenting to optometric practice. Functional and cosmetic outcomes are often excellent but depend on accurate diagnosis, urgent and correct initial management and careful follow‐up. Case reports: We present several cases that highlight important aspects of the clinical care of accommodative esotropia. The first patient was mismanaged by undercorrection of hypermetropia, but was later accurately diagnosed to have accommodative esotropia and was subsequently managed successfully with full hypermetropic correction alone. The second patient had an accommodative esotropia with amblyopia. The third patient used a near addition to correct a residual near esotropia. Conclusions: The published evidence and these cases make several points regarding assessment, diagnosis and management of esotropia. Assessment must aim to reach a diagnosis based on aetiology, as the aetiology of esotropia has a significant impact on management decisions and prognosis.     

调节性内斜视儿童远视矫正后的散光变化

目的 观察调节性内斜视儿童远视矫正后的散光改变.方法 收集看远和看近内斜视10 PD以上、远视1.0 D以上、配戴足矫远视眼镜看远斜视度在10 PD以内的初诊病人;按初诊年龄分为≥2岁＜4岁组和≥4岁＜8岁组;根据睫状肌麻痹检影验光结果予以配戴足矫眼镜.每年再次验光,应用向量分解法,用90°～180°轴向的散光J180,及45°～135°轴向的散光J45作为散光统计指标.连续观察3年以上.结果 符合条件的调节性内斜视儿童共44名,平均初诊年龄(4.7±1.7)岁,观察(4.3±1.4)年.≥2岁＜4岁组儿童右眼的散光J180平均为(0.35 ±0.34)D,在配戴眼镜的第2年和第3年出现了分别为0.28 D、0.20 D的散光增加(P＜0.05),≥4岁＜8岁组右眼的散光J180,平均为(0.34±0.44)D,在戴镜后的第1年和第2年也分别增加了0.22 D和0.18 D(P ＜0.05),两组儿童在随后的2～3年下降到初诊水平并保持稳定;两组儿童的散光J45平均为(0.14±0.16)D、(-0.002±0.16)D,数值小且无明显变化.结论 调节性内斜视配戴远视足矫眼镜以后散光会出现少量的增加,之后有所降低,该变化与最初配戴眼镜的年龄无关.戴镜在一定时期内能影响儿童屈光的发育趋势.     

调节性内斜视眼镜处方方法研究

目的 探讨调节性内斜视最佳配镜处方方法及疗效。方法 55例调节性内斜视患儿,随机分为两组。A组：全矫组,28例,麻痹睫状肌后行远视全矫配镜。B组：同视机组,27例,麻痹睫状肌待瞳孔恢复后,在同视机上观察不同矫正镜片对斜视度、视功能的影响,选择达到双眼最佳融像、眼正位的度数配镜。采用卡方检验比较两组的配镜疗效。结果 经3.5年跟踪观察,B组51.9%患儿配镜度数比总远视度低0.50 D以上,平均（1.38±0.43）D;B组较A组配适好,脱镜现象少;B组远视度平均年降幅比A组大0.64 D;两组立体视恢复率差异无统计学意义。结论 调节性内斜视患儿在同视机及其客观检测指标的指导下进行配镜的方法,可能优于粗略的全矫配镜方法。     

Deterioration of accommodative esotropia during part-time occlusion therapy

The authors report two cases of suddenly deteriorated accommodative esotropia with amblyopia during part-time occlusion therapy. A 7-year-old girl with right accommodative esotropia, which was well controlled, showed marked increase in esodeviation after part-time occlusion and regained orthophoria without occlusion. This phenomenon was repeated. Recession of both medial recti was performed and orthophoria was well maintained at both distant and near targets. Accommodative esotropia of a 9-year-old boy with glasses also showed a striking increase in esodeviation after part-time occlusion. The authors recommended wearing only glasses without occlusion or surgery and he recovered fusion. Three months later, orthophoria was maintained at distant target, with 8PD esophoria at near target with glasses. Although this complication should be considered before occlusion therapy, it must be taken continuously if needed, because an increase of the deviation size with occlusion may simply reflect a true deviation and may not be a poor prognostic sign.     

渐进多焦点镜矫治屈光性调节性内斜视

目的观察渐进多焦点镜在矫治屈光性调节性内斜视合并弱视中的疗效及其对眼球正视化的影响。方法两组屈光性内斜视合并弱视的患儿。第1组:全矫和配戴渐进多焦点镜,视近区远视全部矫正,共41例;第2组:欠矫和配戴单焦点镜,弱视眼的远视欠矫度数为减去检影度数的1/3或1～2DS。戴镜后采用传统遮盖联合其他弱视综合治疗方法。观察治疗前后视力、眼位和屈光状态等的变化情况。结果全矫组患儿34例眼位良好,7例眼位回退,无1例合并间歇性外斜视。全矫组患儿的弱视眼视力恢复至1.0,健眼遮盖的时间平均是(7.3±3.12)个月,而欠矫组需要(10.3±3.21)个月,全矫组遮盖时间平均缩短3个月,两组差异有非常显著性(P<0.01)。治疗前全矫组平均屈光度为( 5.13±1.99)D,治疗后为( 4.20±1.86)D。结论与普通眼镜相比,渐进多焦点眼镜矫治屈光性内斜视合并弱视效果明显。在治疗期间,远视性屈光不正得到全部矫正,有利于视力和眼位的恢复,并可缩短疗程,且不影响眼球的正视化。     

儿童弱视326例的综合治疗效果

目的：探讨儿童弱视综合疗法治疗的疗效观察。 方法：儿童弱视326例485眼，根据弱视程度、弱视类型、注视性质、屈光状态，采取遮盖、压抑、精细目力训练、CAM视觉刺激、红光闪烁、后像、光刷、同视机治疗。 结果：视力增进2行或2行以上者483眼（99．6％）；其中治愈381眼（78．6％）；无效2眼（0．4％）；总有效率99．6％。综合疗法治疗儿童弱视，提高了有效治愈率，弱视程度越轻治疗效果越好。中心注视疗效明显高于旁中心注视，两组治愈率有显著统计学意义（P〈0．01）。各类弱视中以屈光不正性弱视疗效最佳，形觉剥夺性疗效最差。 结论：综合治疗儿童弱视是最理想、最有效的方法，见效快、疗效显著、值得临床推广。     

Outcome in refractive accommodative esotropia

AIM: To examine outcome among children with refractive accommodative esotropia. METHODS: Children with accommodative esotropia associated with hyperopia were included in the study. The features studied were ocular alignment, amblyopia, and the response to treatment, binocular single vision, requirement for surgery, and the change in refraction with age. RESULTS: 103 children with refractive accommodative esotropia were identified. Mean follow up was 4.5 years (range 2-9.5 years). 41 children (39.8%) were fully accommodative (no manifest deviation with full hyperopic correction). The remaining 62 children (60.2%) were partially accommodative. At presentation 61.2% of children were amblyopic in one eye decreasing to 15.5% at the most recent examination. Stereopsis was demonstrated in 89.3% of children at the most recent examination. Mean cycloplegic refraction (dioptres, spherical equivalent) remained stable throughout the follow up period. The mean change in refraction per year was 0.005 dioptres (D) in right eyes (95% CL -0. 0098 to 0.02) and 0.001 D in left eyes (95% CL -0.018 to 0.021). No patients were able to discard their glasses and maintain alignment. CONCLUSIONS: Most children with refractive accommodative esotropia have an excellent outcome in terms of visual acuity and binocular single vision. Current management strategies for this condition result in a marked reduction in the prevalence of amblyopia compared with the prevalence at presentation. The degree of hyperopia, however, remains unchanged with poor prospects for discontinuing glasses wear. The possibility that long term full time glasses wear impedes emmetropisation must be considered. It is also conceivable, however, that these children may behave differently with normal and be predestined to remain hyperopic.