角膜塑形鏡矯正近視性屈光參差對(duì)雙眼視功能的影響

蘭小川，石春和

?

·臨床報(bào)告·

角膜塑形鏡矯正近視性屈光參差對(duì)雙眼視功能的影響

蘭小川，石春和

?METHODS: A total of 40 cases of myopic anisometropia corrected by Ortho K contact lens were collected. The average age of participants was 11.32±2.56y. The refractive error varied from -1.25D to -5.75D, on average -3.18±1.12D. The amount of myopic anisometropia was -4.64±1.52D. All the cases were followed-up for 3mo. The uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), refraction and binocular vision were checked pre-wearing Ortho K contact lens, and 3mo post wearing respectively.

?RESULTS:The mean UCVA was 4.0±0.2, and BCVA was 4.96±0.2, the amount of myopic anisometropia was -4.64±1.52D pre-wearing OK contact lens. The mean UCVA was 4.97±0.07, and BCVA was 4.99±0.1, the amount of myopic anisometropia was 0.23±0.12D, at post wearing OK lens 3 months respectively. The UCVA, BCVA, the amount of myopic anisometropia at post correction was significantly difference with pre-correction (P<0.05). Before correction, 36 cases got simultaneous binocular visions, 21 cases got combined visions, 13 cases got long distance stereopsis visions. Simultaneous binocular visions existed in 40 cases, combined visions existed in 36 cases, long distance stereopsis visions existed in 23 cases post correction 3mo. Compared with pre-correction, the difference was significantly. Before correction, 14 cases had macular fovea stereo vision. Abnormal stereo vision existed in 26 cases, including 13 cases with macula stereo vision, 7 cases with peripheral stereo vision, and 6 cases with stereo vision blind. Macular fovea stereo vision was found in 27 cases, Abnormal stereo vision existed in 13 cases, including 7 cases with macula stereo vision, 3 cases with peripheral stereo vision, and 3 cases with stereo vision blind after wearing Ortho K contact lens 3mo.

?CONCLUSION:Most myopic anisometropia patients can improve their visual acuity, reduce the refractive difference, and increase combined and stereopsis vision after wearing Ortho K contact lens 3mo.

目的：觀察近視性屈光參差患者配戴角膜塑形鏡后雙眼視功能的變化。

方法：選取40例配戴角膜塑形鏡的近視性屈光參差患者，觀察配戴前和配戴3mo后裸眼視力(uncorrected visual acuity，UCVA)、最佳矯正視力(best corrected visual acuity，BCVA)、屈光參差度、同視機(jī)雙眼視功能、近立體視功能的變化。

結(jié)果：配戴前平均UCVA為4.0±0.2，BCVA為4.96±0.2，屈光參差度-4.64±1.52D；配戴3mo后平均UCVA為4.97±0.07，BCVA為4.99±0.1，屈光參差度為0.23±0.12D；配戴3mo后與配戴前比較，差異均有統(tǒng)計(jì)學(xué)意義(P<0.05)。配戴前擁有同時(shí)視者36例、融合功能21例、遠(yuǎn)立體視功能13例。配戴3mo后分別為40例、36例、23例。配戴后獲得融合功能和遠(yuǎn)立體視者較配戴前增加，與配戴前比較有統(tǒng)計(jì)學(xué)差異(P<0.05)。配戴角膜塑形鏡前，框架眼鏡矯正后近立體視正常者14例，近立體視異常者26例(13例黃斑立體視，7例周邊立體視，6例立體盲)。配戴3mo后近立體視正常者27例，近立體視異常者13例(7例黃斑立體視，3例周邊立體視，3例立體盲)。配戴后3mo的近立體視與配戴前比較，差異有統(tǒng)計(jì)學(xué)意義(P=0.004)。

結(jié)論：配戴角膜塑形鏡矯正近視性屈光參差3mo后，不僅裸眼視力得到提高，而且可以改善立體視功能。

近視眼；屈光參差；角膜塑形術(shù)；雙眼視覺(jué)；立體視

引用：蘭小川，石春和.角膜塑形鏡矯正近視性屈光參差對(duì)雙眼視功能的影響.國(guó)際眼科雜志2016;16(12):2356-2358

0引言

屈光參差是雙眼在一條或兩條子午線上的屈光力存在差異。在青少年近視患者中，復(fù)性近視性屈光參差比較常見(jiàn)，即雙眼均為近視，雙眼屈光度之差≥1D。屈光參差會(huì)嚴(yán)重?fù)p害患者的視功能，其引起的視像不等和視物模糊可引起單眼抑制，造成單眼視、弱視，并導(dǎo)致立體視功能的下降。因此矯正屈光參差，不僅要獲得最佳視力，防止形成弱視，同時(shí)也要恢復(fù)和重建立體視，達(dá)到理想的功能治愈。角膜塑形鏡已經(jīng)被廣泛應(yīng)用在臨床，作為一種可逆的非手術(shù)的治療手段，用來(lái)矯正近視，并能延緩控制近視度數(shù)的加深。本研究觀察了近視性屈光參差患者配戴角膜塑形鏡后雙眼視功能的變化，以探討近視性屈光參差患者通過(guò)配戴角膜塑形鏡來(lái)恢復(fù)雙眼視功能的可能性。……