天津医药

天津医药 ›› 2021, Vol. 49 ›› Issue (7): 727-730.doi: 10.11958/20210052

• 临床研究 • 上一篇    下一篇

传统弱视治疗联合调节训练对屈光异常弱视儿童的治疗效果评价价

冯鑫媛，南莉，田璐   

  1. 天津市眼科医院，天津市眼科学与视觉科学重点实验室，天津市眼科研究所，天津医科大学眼科临床学院（邮编300020）
  • 收稿日期:2021-01-13 修回日期:2021-04-10 出版日期:2021-07-15 发布日期:2021-07-12
  • 作者简介:冯鑫媛（1993），女，硕士，住院医师，主要从事眼表疾病研究。E-mail：2334439172@qq.com
  • 基金资助:
    天津市自然科学基金项目（18JCZDJC36400）

Comprehensive therapeutic effect of traditional treatment combined with accommodation training in amblyopia children of refractive abnormalities

FENG Xin-yuan, NAN Li, TIAN Lu   

  1. Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Institute of Ophthalmology, Clinical College of Ophthalmology of Tianjin Medical University, Tianjin 300020, China
  • Received:2021-01-13 Revised:2021-04-10 Published:2021-07-15 Online:2021-07-12

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摘要： 目的　评价传统弱视治疗联合调节训练对不同年龄、屈光状态、屈光类型及严重程度的弱视儿童的治疗效果。方法　纳入我院弱视训练室收治的弱视患儿83例（112眼），所有患儿均在屈光矫正前提下进行调节训练治疗，单眼弱视儿童同时应用遮盖治疗。根据不同年龄、不同屈光类型、不同屈光状态及弱视严重程度分组，分析不同组间患儿的临床治疗效果。结果　83例（112眼）中学龄前患儿33例（44眼），学龄50例（68眼）；屈光参差47例（49眼），屈光不正36例（63眼）；单纯远视5例（6眼），远视散光67例（88眼），近视散光11例（18眼）；轻度弱视44眼，中度65眼，重度3眼。弱视患儿治疗总有效率为91.1%（102/112眼），学龄前组最佳矫正视力（BCVA）提高程度显著高于学龄组（P＜0.05）；屈光参差组BCVA提高程度显著高于屈光不正组（P＜0.05）；远视散光组总有效率显著高于近视散光组和单纯远视组（P＜0.01），而近视散光组与单纯远视组有效率差异无统计学意义；轻度组治疗效果显著好于中度组及重度组（P＜0.01），中度组和重度组治疗效果差异无统计学意义，但重度组BCVA变化显著大于轻度组和中度组（P＜0.01），中度组BCVA变化显著大于轻度组（P＜0.01）。结论　传统弱视治疗联合调节训练可以有效提高患儿视力，学龄前、屈光参差及中、重度弱视患儿BCVA提高显著，远视散光患儿治疗有效率高，轻度组疗效好。

关键词: 弱视, 屈光, 眼, 调节, 眼

Abstract: Objective　To evaluate the effect of traditional treatment combined with accommodation training in amblyopic children with different ages, different refractive states, different refractive types and different severity. Methods　A total of 83 children (112 eyes) with amblyopia were enrolled in the amblyopia training room of our hospital. All children were treated with traditional treatment combined with accommodation training under the premise of refractive correction, and children with monocular amblyopia were treated with covering therapy at the same time. According to different ages, different refractive types, different refractive states and amblyopic severity, the clinical therapeutic effects of amblyopic children were analyzed in different groups. Results　Among 83 cases (112 eyes), 33 children (44 eyes) were preschool age, 50 children (68 eyes) were school age, 47 children (49 eyes) were anisometropia and 36 (63 eyes) were ametropia. There were 5 children (6 eyes) of hyperopia, 67 (88 eyes) of hyperopic astigmatism and 11 (18 eyes) of myopic astigmatism. Forty-four eyes were mild amblyopia, 65 eyes were moderate amblyopia and 3 eyes were severe amblyopia. The total effective rate of amblyopia was 91.1% (102/112 eyes). The improvement of best corrected visual acuity (BCVA) was significantly higher in the preschool age group than that in the school age group (P＜0.05). The improvement of BCVA was significantly higher in the anisometropia group than that in the ametropia group (P＜0.05).The total effective rate was significantly higher in the hyperopic astigmatism group than that of the myopic astigmatism group and the simple hyperopia group (P＜0.01), but there was no significant difference in the total effective rate between the myopic astigmatism group and the simple hyperopia group. The therapeutic effect was significantly better in the mild group than that of the moderate group and the severe group (P＜0.01), but there was no significant difference between moderate group and severe group. The BCVA improvement was significantly higher in the severe group than that in the other two groups (P＜0.01), where as the changes of BCVA was significantly higher in the moderate group than that of the mild group (P＜0.01). Conclusion　Traditional amblyopia treatment combined with accommodation training can effectively improve the visual acuity of children. The BCVA improvement increases significantly in preschool age, anisometropia, moderate and severe amblyopia children. The effective rate of hyperopic astigmatism is high, and the mild group has good curative effect.

Key words: amblyopia, refraction, ocular, accommodation, ocular