不同屈光矫正方法治疗高AC/A调节性内斜视的疗效观察  

Effect of different refractive correction therapy on the treatment of high AC/A ratio accommodative esotropia

作　　者：王雅晨 程璐瑶 常笛 刘志瀚 张维嘉 傅涛 Wang Yachen;Cheng Luyao;Chang Di;Liu Zhihan;Zhang Weijia;Fu Tao(Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Key Laboratory of Ophthalmology and Visual Sciences,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院北京同仁眼科中心眼科学与视觉科学北京市重点实验室,北京100730

出　　处：《眼科》2023年第6期488-491,共4页Ophthalmology in China

基　　金：国家自然科学基金(82071001);北京市自然科学基金(7222030)。

摘　　要：目的比较双光镜、渐近多焦镜和单光镜对高AC/A调节性内斜视患者立体视觉的恢复效果。设计前瞻性病例系列。研究对象高AC/A调节性内斜视患儿57例,其中配戴渐进多焦镜、双光眼镜、单光眼镜分别为18、23、16例。方法三组患者视远均足矫。渐进多焦点镜片和双光眼镜的下加屈光度为+2.50~+3.00 D,随访3~5年,记录戴镜前后的视远、视近斜视度、AC/A值和近立体视觉的变化并进行统计分析。主要指标看近眼位正位率、AC/A值、近立体视觉。结果三组患者的年龄、性别、屈光状态、治疗前AC/A均无显著差异(P均>0.05),治疗前三组患者近立体视均检测不出。治疗后双光镜、渐近多焦镜和单光镜组患者看近眼位正位率分别为10/23(43%)、10/18(56%)、6/16(38%)无显著差异(χ^(2)=0.71,P=0.70);治疗后三组患儿的近立体视觉均有改善,分别为(6.79±1.67)lnArcsec、(7.43±1.50)lnArcsec、(7.41±1.48)lnArcsec,但三组间差异无统计学意义(F=1.12,P=0.33)。结论单光眼镜与渐进多焦镜和双光眼镜对改善高AC/A调节性内斜视的眼位和近立体视觉有相似的治疗效果。Objective To compare the effect of bifocal lenses,progressive addition lenses and single vision lenses on stereoscopic vision recovery in patients with high AC/A ratio esotropia.Design Prospective study.Participants A total of 57 cases were enrolled,including 18 cases with progressive addition lenses,23 cases with bifocal lenses,and 16 cases with single vision lenses.Methods All patients in the three groups had full orthoptic correction and were in the orthoptic position when viewing the distance.The additional diopter of progressive addition lenses and bifocal lenses was+2.50~+3.00 D.After 3~5 years’follow-up,the differences of deviation at distance and near,AC/A ratio and near stereoscopic vision in each group after the treatment were statistically analyzed.Main Outcome Measures Orthotropic rate at near,AC/A ratio,near stereoscopic vision.Results There were no significant differences of the baseline data of age,gender,refractive status,AC/A before treatment among the three groups(all P>0.05),the stereoscopic vision of the three groups was all lost before treatment.After follow-up of 3~5 years,the orthotropic rate at near of the bifocal lenses,progressive addition lenses and single vision lenses groups was 10/23(43%),10/18(56%),and 6/16(38%),respectively(χ^(2)=0.71,P=0.70).The stereoscopic vision of patients in the three groups was improved to(6.79±1.67)lnArcsec,(7.43±1.50)lnArcsec,and(7.41±1.48)lnArcsec,but there was no statistically significant difference among the three groups(F=1.12,P=0.33).Conclusion Bifocal lenses,progressive addition lenses,and single vision lenses have a similar therapeutic effect on high AC/A ratio esotropia.

关 键 词：高AC/A调节性内斜视 渐进多焦镜 双光镜 单光镜 

分 类 号：R777.41[医药卫生—眼科]