近距外隐斜近视儿童的个性化近附加研究  

Study on the customized near addition lens for exophoric myopic children

作　　者：吕文汇[1] 保金华[1] 余新平[1] 吕帆[1] 

机构地区：[1]温州医科大学眼视光学院,浙江温州325000

出　　处：《中国实用眼科杂志》2014年第10期1183-1186,共4页Chinese Journal of Practical Ophthalmology

基　　金：国家自然科学基金项目（81170869）;浙江省重点科技创新团队计划资助（眼科创新团队,2009R50039;2011R09039-08）

摘　　要：目的 研究在平衡双眼调节与集合的基础上,最适合近距外隐斜近视儿童的近附加度数.方法 临床病例系列研究.对2013年6～9月在温州医科大学眼视光医院纳入30例近距外隐斜近视儿童,采用Grand Seiko红外电脑验光仪测量受试者右眼在不同近附加下的近距调节反应;采用VonGraefe法测量受试者不同近附加下的近距外隐斜量;通过综合验光仪测量受试者不同近附加下的BO值（正融像性聚散）.结果 随着近附加度数的增加,调节反应量及外隐斜量逐渐增加,二者在不同近附加下差异均有统计学意义（P＜0.01）,BO值无明显变化.不同近附加下的调节反应量与近附加度数存在差异有统计学意义（r=0.715,P＜0.01）,不同近附加下的近隐斜量与近附加度数存在差异有统计学意义（r=-0.936,P＜0.01）;在最适近附加（即个体调节反应与调节刺激相等时的近附加度数）与初始调节反应量之间,未能建立有统计学意义的回归方程（P＞0.05）.结论 调节反应和近距隐斜量存在较大的个体差异,近距外隐斜近视儿童验配渐变镜时,更需要在尽量减少患者调节滞后的基础上,保持良好地双眼视觉及聚散平衡.Objective To investigate the optimal adds for exophoric myopic children on the basis of combine with accommodation and convergence.Methods A total of 30 exophoric myopic children participated in this study.Accommodative response was measured by Grand Seiko auto-refractor in 33 cm with different near adds,the near exophoria was measured by the Von Graefe method in 33 cm with different near adds,and the base-out fusional range was measured by the Phoropter.Results While increasing the near adds,accommodative response and near exophoria increase gradually,both accommodative response and near exophoria showed statistically significant difference among the different near adds,and there was no significant change of base-out fusional range.There was linear correlation between the different near adds and the accommodative response（r =0.715,P 〈 0.001） and between the different near adds and the near exophoria（r =-0.936,P 〈0.001）,it was failed to find out the statistically linear correlation between the optimal adds（which would make the accommodative response was equal to the accommodative stimulation）and initial accommodative response （P 〉0.05）.Conclusions There is a big individual difference for accommodative response and near phoria.When fitting the progressive addition lenses for exophoric myopic children,it is important to maintain a good balance between binocular vision and vergence on the basis of the least accommodative lag.

关 键 词：调节反应 近附加 外隐斜 近视儿童 

分 类 号：R778.14[医药卫生—眼科]