集合不足型外隐斜合并调节不足三种治疗方法的比较

摘要

目的 比较集合调节训练、三棱镜配戴矫正和近视屈光过矫在集合不足型外隐斜合并调节不足患者中的疗效.方法 横断面研究,将10～35岁的60名确诊为集合不足型外隐斜合并调节不足患者随机分为3组,每组20例,A组行三棱镜配戴矫正,B组行近视屈光过矫-0.50 D戴镜矫正,C组行集合调节视功能训练,于3个月后复查隐斜度和视功能采用配对t检验和单因采方差分析 结果 复查各项视功能参数3组患者之间差异有统计学总义 A组患者隐斜度增加(t=1 2.65,P＜0.01),近距正相对融合范围减小(t=12.65,P＜0.01),症状先短暂缓解后加重；B组患者隐斜度增加(t=4.63,P＜0.01),近距正E相对融合范围减小(t＝6.71,P＜0.01),调节幅度减小(t=14.3,P＜0.01),症状明显加重；C组患者隐斜度显著减小(t=-11.61,P＜0.01),近距正相对融合范围显著增大(t=-22.40,P＜0.01),调节幅度显著增大(t=-31.06,P＜0.01),症状明显改善 结论 集合不足型外隐斜合并调节不足患者采用集合调节视功能训练能明显改善症状,减少近距隐斜度,增加近距正相对融合范围和调节幅度,是一种有效可行的治疗方法.%Objective Compare the effectiveness of three treatment methods,namely the “convergence and accommodation training",the “correction of weared prism" and the “overcorrection of Myopic refractive" in patients with convergence insufficient exophoria accompanying with accommodative insufficiency.Methods It was a cross-sectional study.Sixty patients between 10 and 35 years' old who are diagnosed with convergence insufficient exophoria accompanying with accommodative insufficiency were randomly divided into three groups with 20 cases in each group.Patients in group A were corrected by weared prism,patients in group B were trated by the overcorrection of Myopic refractive (-0.50 D spectacles correction),patients in group C were treaded by convergence and accommodation visual function raining.Their phoria and visual functions were reviewed after three months.Results There are significant differences among the function parameters of the three groups of patients after review their visuals in three months' time.The heterophoria diopter increased in group A patients (t＝12.65、P＜0.01).The range of near-distance positive relative convergence has reduced (t=12.65,P＜0.01),after a short reduce,the symptoms of the patients in this group have increased.The heterophoria diopter of the patients in Group B has increased (t=4.63,P＜0.01).The range of near-distance positive relative convergence has reduced (t=6.71,P＜0.01).The accommodative amplitude decreased (t=14.3,P＜0.01) and the symptoms got worse significantly.However,the heterophoria diopter has significantly reduced in patients of group C (t=-1 1.61,P＜0.01).Their range of near-distance positive relative convergence has significantly increased (t=-22.40,P＜0.01),the accommodative amplitude (t=-31.06,P＜0.01) has increased significantly as well.Thesymptoms were improved significantly.Conclusion After the treatment of the convergence and accommodation visual function raining,the symptoms of the patients diagnosed with convergence insufficient exophoriaaccompanying with accommodative insufficiency were improved significantly,their heterophoria dioptcr has reduced,and the range of near-distance positive relative convergence and the accommodative amplitude has increased.In summary,this treatment is a feasible and effective treatment.