先天性上睑下垂综合治疗后视功能及屈光状态的临床观察

目的探讨先天性上睑下垂综合治疗后视功能及屈光状态的变化规律。方法对30例（52只眼）先天性上睑下垂患者采用综合治疗,于治疗前、治疗后1个月、6个月行视力检查及视觉诱发电位（P-VEP）检查,于治疗前和治疗后6个月行医学验光。结果先天性上睑下垂综合治疗后1个月及6个月裸眼视力（UCVA）、最佳矫正视力（BCVA）较治疗前提高,治疗后1个月P100（1°）潜伏期、治疗后6个月P100（2°及1°）潜伏期较治疗前缩短,差异有统计学意义（P均〈0.05）;治疗后6个月等效屈光度（SE）、散光度数及散光轴位与治疗前差异无统计学意义（P均〉0.05）。轻中度先天性上睑下垂治疗后1个月及6个月UCVA、治疗后6个月BCVA较治疗前提高,治疗后6个月P100潜伏期（2°及1°）较治疗前缩短,差异有统计学意义（P均〈0.05）。重度先天性上睑下垂治疗后1个月UCVA、治疗后1个月及6个月BCVA较治疗前提高,治疗后6个月P100潜伏期（2°）较治疗前缩短、P100振幅（1°）较治疗前提高,差异有统计学意义（P均〈0.05）。结论无论是轻中度还是重度先天性上睑下垂,综合治疗后视功能均有明显提高,但两者视力及P-VEP的变化规律存在一定的差异。无论是轻中度还是重度先天性上睑下垂,综合治疗后屈光状态改变均不明显。

Visual function changes after multimodality therapyfor congenital ptosis

Objective To investigate the effects of multimodality therapy on visual functions of congenital ptosis patients. Methods A total 30 congenital ptosis patients（52 eyes） were involved in the study. Patients were tested for visual acuity,refraction,and pattern visual evoked potential（P-VEP） before and after a multimodality therapy was completed. The multimodality therapy plan included surgical correction,ocular surface maintenance,and visual function rehabilitation. Results Visual acuity（VA） and best-corrected visual acuity（BCVA） at 1 month and 6 months after the completion of the treatment significantly improved（ P 〈0. 05）. P100 latency of central 1° significantly reduced at 1 month and 6months after the treatment（ P〈 0. 05）,and P100 latency of central 2°reduced at 6 months（ P〈 0. 05）. There were no significant changes in spherical equivalent（SE）,astigmatism and astigmatic axis. These improvements in visual functions and P-VEP were observed in all patients regardless the severity of the ptosis. Conclusion Multimodality therapyimproves visual acuity in patients with mild or severe ptosis. The underlying mechanism appears due to better cortical responses as evidenced by improved P-VEP parameters.