散光对儿童眼球正视化及弱视治疗效果的影响  

Effect of astigmatism on emmetropization and treatment of amblyopia in young children

作　　者：付景珂[1] 胡聪[2] 李霞 何峰丽 

机构地区：[1]青岛市第八人民医院眼科,山东青岛266100 [2]青岛大学医学院眼科,山东青岛266003 [3]平度市第五人民医院眼科,山东平度266742

出　　处：《中华眼视光学与视觉科学杂志》2010年第5期371-374,共4页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：目的 探讨不同程度的散光对远视儿童眼球正视化进程及视力变化的影响,从而为临床上此类患儿的屈光矫正、弱视治疗提供参考.方法 回顾性病例系列研究.收集1999年10月至2008年2月期间连续就诊时间长达5年及以上且病例资料完整的4～11岁远视患儿138例（258眼）,按散光程度分为对照组（散光≤0.5 D,107眼）、散光1组（0.5 D＜散光＜1.0 D,85眼）和散光2组（散光≥1.0 D,66眼）.比较5年中各组内相邻两年间及组间的球镜度数、视力差异,比较首次与第5年末散光度数的差异.年间、组间球性屈光度数及视力的比较采用方差分析,首次检查与末次检查时的散光度数的差异采用配对t检验进行分析.结果 对照组与散光1组的首次检查及第1、2、3年末的屈光度数相邻两年间球镜度数差异均有统计学意义（P＜0.05）;第3与第4年、第4与第5年末球镜度数差异均无统计学意义.散光2组的6次检查相邻两年间差异均有统计学意义（P＜0.05）.对照组与散光1组对应时间点两组间球镜度数差异均无统计学意义.3组患儿的球镜度数在首次及第1、2、3年末差异无统计学意义;第4、5年末,3组间的差异有统计学意义（F值分别为5.06、7.58,P＜0.05）.对照组与散光1组首次与第1、2年末的矫正视力差异有统计学意义（P＜0.05）;其他相邻两年间差异无统计学意义.散光2组首次与第1年末矫正视力差异有统计学意义（P＜0.05）;其他相邻两年间的矫正视力差异无统计学意义.对照组与散光1组对应时间点两组间矫正视力的差异无统计学意义.散光2组与其他两组患儿的矫正视力在首次及第1年末差异无统计学意义,在第2、3、4、5年末时差异有统计学意义（P＜0.05）.散光2组5年后的散光度数明显下降,差异有统计学意义（t=3.1440,P=0.021）.结论 ≥1.0 D的散光可促进远视眼的正视化进程,但不利于弱视的治疗.轻度的�Objective To investigate the effect of different astigmatisms on emmetropization and amblyopia. Methods Retrospective case series study. Two hundred and fifty-eight eyes of 138 children were divided into 3 groups： a normal control group （107 eyes） and an astigmatism group 1 （85 eyes） and group 2 （66 eyes） according to their degree of astigmatism.Refractive status and visual acuity （VA） were measured and compared at the beginning and at 1,2, 3, 4 and 5 years. Astigmatism was measured and compared at the beginning and end. Results Refractive status： the normal control group and the astigmatism group 1 had a significant decrease in refractive status at 1, 2 and 3 years （P〈0.05 for both）. Astigmatism group 2 had a significant decrease in refractive status every year （F=24.65, P〈0.05）. No significant differences were found in refractive status when the normal control and the astigmatism group 1 were compared at corresponding times. Significant differences were found in years 4 and 5 between the astigmatism group 2 and the other two groups. Visual acuity： the normal control and astigmatism group 1 had a significant improvement in visual acuity in years 1 and 2; there was a significant improvement in year 1 in the astigmatism group 2. The intergroup results for corresponding times were not statistically significant for the normal control and astigmatism group 1. There was a statistically significant difference between astigmatism groups 2 and 1, and between group 2 and the normal group in years 2, 3, 4 and 5.The amount of astigmatism decreased significantly in the astigmatism group 2 between the first and last check-ups （t=3.1440, P=0.021）. Conclusion Astigmatism≥ 1.0 D is found to accelerate emmetropization. But amblyopia could not be completely cured. Astigmatism〈1.0 D has no influence on emmetropization and amblyopia.

关 键 词：散光 正视化 弱视 儿童 

分 类 号：R777.44[医药卫生—眼科]