硬性透气性角膜接触镜与框架眼镜矫正婴幼儿先天性白内障术后无晶状体眼的对比研究  

A comparative study of rigid gas permeable corneal contact lenses versus frame glasses for refractive correction of postoperative aphakic eyes after congenital cataract surgery in infants and children

作　　者：林赛柔 焦永红 成娟娟 刘立洲 胡健萍 Lin Sairou;Jiao Yonghong;Cheng Juanjuan;Liu Lizhou;Hu Jianping(Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Institute of Ophthalmology,Beijing Key Laboratory of Ophthalmology&Visual Sciences,Beijing 100730,China;Department of Ophthalmology,Beijing Tsinghua Changgung Hospital affiliated to Tsinghua University,Beijing 102218,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、北京市眼科研究所、北京市眼科学与视觉科学重点实验室,北京100730 [2]清华大学附属北京清华长庚医院眼科,北京102218

出　　处：《中华眼科杂志》2024年第4期343-351,共9页Chinese Journal of Ophthalmology

基　　金：北京市医院管理局临床技术创新项目(XMLX201804)。

摘　　要：目的比较先天性白内障术后无晶状体眼患儿使用硬性透气性角膜接触镜(RGPCL)和框架眼镜进行屈光矫正的效果和影响因素。方法前瞻性非随机对照试验。连续收集2012年4月至2019年11月于首都医科大学附属北京同仁医院斜视与小儿眼科门诊进行视力矫正的先天性白内障术后无晶状体眼患儿, 将自主选择配戴RGPCL进行屈光矫正者纳入试验组, 其中单眼发病者为试验1组, 双眼发病者为试验2组;将术后自主选择配戴框架眼镜进行屈光矫正者纳入对照组, 其中单眼发病者为对照1组, 双眼发病者为对照2组。首诊时采集患儿地区来源、病史和家庭情况等信息。随访时记录戴镜过程中出现的不良反应;采用Teller视敏度卡进行视力检查获取最佳矫正视力并转换为最小分辨角的对数;根据眼球震颤振幅和频率确定眼球震颤的程度;分析治疗费用、遮盖治疗依从性;对患儿家长进行采用或不采用RGPCL原因的问卷调查。结果最终纳入先天性白内障术后患儿203例(344只眼), 其中男性124例(210只眼), 女性79例(134只眼);年龄为3~36个月。试验组28例, 其中试验1组19例, 双眼试验2组9例;对照组175例, 其中对照1组43例, 对照2组132例。除6月龄外, 其余各月龄的试验组患儿视力均优于对照组患儿, 差异均具有统计学意义(P<0.05)。试验1组患儿各月龄视力均优于对照1组同月龄患儿视力, 其中12月龄[1.54(1.27, 1.97)、1.84(0.97, 2.12)]、18月龄[1.27(0.97, 1.84)、1.84(0.97, 2.12)]、24月龄[1.27(0.66, 1.54)、1.54(0.66, 2.12)]及30月龄[0.97(0.66, 1.27)、1.54(0.66, 2.12)]视力的差异有统计学意义(P<0.001);试验2组患儿各月龄视力均优于对照2组同月龄患儿视力, 其中18月龄[1.27(0.97, 1.54)、1.27(0.66, 2.12)]、24月龄[0.97(0.66, 1.27)、1.27(0.66, 2.12)]及30月龄[0.66(0.66, 1.27)、1.27(0.66, 2.12)]视力差异有统计学意义(P<0.05)。试验组眼球震颤缓解率为8/9(8例), 对Objective The aim of this paper is to compare the refractive correction effects of rigid gas permeable contact lenses(RGPCL)and spectacle correction in children with aphakia after congenital cataract surgery.Methods This was a prospective non-randomized controlled trial.Children with aphakic eyes after congenital cataract surgery,who underwent vision correction in the Strabismus and Pediatric Ophthalmology Clinic of Beijing Tongren Hospital affiliated with Capital Medical University from April 2012 to November 2019,were continuously collected.Those who voluntarily chose to wear RGPCL for refractive correction were included in the experimental group.Patients with monocular disease were in trial group 1,and patients with binocular disease were in trial group 2.Patients who chose to wear frame glasses for refractive correction were included in the control group.Patients with monocular disease were in control group 1,and patients with binocular disease were in control group 2.Regional origin,medical history,and family information were collected at the first diagnosis.During the follow-up,adverse reactions occurring during the process of wearing glasses were recorded.The Teller acuity card was used for visual examination to obtain the best-corrected visual acuity and convert it into the logarithm of the minimum resolution angle.The degree of nystagmus was determined according to the amplitude and frequency of nystagmus.Treatment cost,treatment compliance,and the reasons for adopting or not adopting RGPCL were analyzed through a questionnaire completed by the parents of children with RGPCL.Results A total of 203 children(344 eyes)who underwent congenital cataract surgery were included,including 124 males(210 eyes)and 79 females(134 eyes).The age range was 3 to 36 months.There were 28 cases in the experimental group,including 19 cases in trial group 1 and 9 cases in trial group 2.There were 175 cases in the control group,including 43 cases in control group 1 and 132 cases in control group 2.Except for 6 months of age,th

关 键 词：接触镜 眼镜 无晶状体 白内障后 视敏度 对比研究 婴儿 

分 类 号：R779.6[医药卫生—眼科]