单纯屈光矫正治疗儿童青少年屈光不正性弱视的疗效观察

目的:研究双眼屈光不正性弱视患者单纯屈光矫正后的治疗效果。方法:根据国内最新弱视诊断标准,对确诊为双眼屈光不正性弱视患者58例(116只眼)使用1%硫酸阿托品眼用凝胶点双眼,睫状肌麻痹后验光,按MPMVA原则根据患者年龄并结合患者眼位(隐斜)给予全矫或保留生理性的远视度数,散光足矫,然后随访追踪患者戴镜后3、6个月及1年时的视力。结果:屈光矫正3个月时视力达到同龄儿童视力参考值下限的有57只眼(49.1%),6个月时有84只眼(72.4%),1年时有102只眼(87.9%)。随访1年时视力平均提高(3.59±2.04)行,其中视力提高≥2行的弱视眼占90.5%(105只眼);100.0%(38只眼)中度远视患者、82.4%(28只眼)高度远视患者、83.3%(30只眼)远视散光患者以及75.0%(6只眼)混合散光患者达到同龄儿童视力参考值下限,50.0%(9只眼)≥8岁患者视力达1.0。结论:多数屈光不正性弱视患者仅通过单纯屈光矫正治疗可取得良好的治疗效果,准确的验光和正确的屈光矫正方法是提高这类弱视患者视力的关键。

Observation on the therapeutic effect of simple correction of refractive error for treatment of children and adolescents with ametropic amblyopia

Objective:To research the therapeutic effect of simple correction of refractive error for treatment of children and adolescents with ametropic amblyopia. Methods:According to the newest diagnostic criteria of amblyopia in China,58 patients(116 eyes) who were diagnosed as bilateral ametropic amblyopia definitely were treated with eye dropping with 1% atropine sulphate gel,optometry was performed after cycloplegia;according to MPMVA principle,age,and eye position(heterophoria),simple correction of refractive error was conducted or physiological hyperopia degree was conserved;at three months,six months,and one year after wearing glasses,eyesights of the patients were followed up. Results:At three months after simple correction of refractive error,57 eyes reached the low limit of the normal reference of healthy children vision,accounting for 49.1%;at six months after simple correction of refractive error,84 eyes reached the low limit of the normal reference of healthy children vision,accounting for 72.4%;at one year after simple correction of refractive error,102 eyes reached the low limit of the normal reference of healthy children vision,accounting for 87.9%.At one year after simple correction of refractive error,the mean eyesight was improved by(3.59±2.04) lines,and the mean eyesight of 90.5%(105/116) of them was improved by more than 2 lines;100.0%(38 eyes) of the patients with moderate hyperopia,82.4%(28 eyes) of the patients with severe hyperopia,83.3%(30 eyes) of the patients with hyperopia and astigmatism,and 75.0%(6 eyes) of the patients with mixed astigmatism reached the low limit of the normal reference of healthy children vision,the eyesight of 50.0%(9 eyes) of the patients who were eight years old or more than eight years old reached 1.0. Conclusion:Most of the patients with ametropic amblyopia only can reach good therapeutic effect by simple correction of refractive error,accurate optometry and proper method to correct ametropia are key points to improve eyesight of the patients.