双眼交替遮盖与单眼部分遮盖治疗屈光不正性弱视的疗效比较

目的研究双眼交替遮盖与单眼部分遮盖治疗屈光不正性弱视的疗效有无差异。方法经散瞳验光后按纳入和排除标准筛选出318例(636只弱视眼)屈光不正性弱视患儿,按屈光度分成近视性,远视性,混合散光性弱视3组,再依据随机对照原则将各弱视组内患儿分成两组,分别用双眼交替遮盖(3～5∶1d)和单眼部分遮盖(4～8h/d)进行治疗,各组都同时辅以增视能视觉训练,6个月后,分别在不同类型弱视组按弱视程度(轻度、中度、重度)比较两种遮盖方法的视力提升效果,统计学方法用χ2检验。同时比较两种遮盖方法对屈光不正性弱视双眼视功能(融合范围和立体视锐度)的改善情况,用t检验。结果在3种屈光不正性弱视中双眼交替遮盖组与单眼部分遮盖组使轻度、中度、重度弱视眼视力进步的有效率分别经χ2检验后差异均无统计学意义(P>0.05)。对双眼视功能改善,对比两种方法治疗前后水平融合范围扩大5°以上的人数及立体视锐度SA≤60″人数变化,分别经t检,差异均有统计学意义(P<0.05)。结论单眼部分遮盖对屈光不正性弱视视力提升效果与双眼交替遮盖基本一致,但对双眼视功能(融合功能,立体视觉)的改善优于后者,说明单眼部分遮盖更有利于患儿双眼视的恢复。

Alternate occlusion compared to part-time occlusion for the treatment of ametropic amblyopia

Objective To explore and compare the efect between alternate occlusion and part-time occlusion for the treatment of ametropic amblyopia.Methods The prospective study is conducted on 318 children(ages 3 to 7 years)with ametropic amblyopia.,including three groups:hypermetropic,myopic and mixed astigmatic amblyopia.Each group had been randomly divided into the alternate occlusion group and the part-time occlusion(4 to 8 hours one day)group,and at the same time,all patients were trained by Zengshineng.After 6 months,we compared the effect(the improvement of visual acuity and binocular vison)between the two methods.Results After the statistical analysis,the recovery rate of visual acuity shows no significant difference between the two methods groups in each type of amblyopia,while in improving binocular vison the differences are significant between the two methods.Conclusion The effect of the two methods in improving visual acuity is consistent and part-time occlusion is superior to alternate occlusion in improving binocular vison.