目的 调查单眼远视性屈光参差性弱视患儿视觉康复过程中视力和调节功能的康复情况，研究视力恢复后调节功能是否同步恢复。方法 横断面研究。收集正常儿童50例作为对照组，远视性屈光参差性弱视（单眼弱视）治愈儿童55例作为实验组，采用SRW-5500红外自动验光仪检查这些患儿在阅读距离为20、33、50 cm时的调节反应（双眼同时注视），采用公式——调节滞后=调节需求-调节反应，来计算调节滞后量。采用独立样本t检验、配对t检验和相关性分析对数据进行处理。结果 阅读距离为20、33、50 cm时，正常组主导眼调节滞后量分别为(0.26±0.31)、(0.12±0.02)、(0.10±0.01)D；非主导眼分别为(0.27±0.30)、(0.17±0.14)、(0.12±0.01)D。弱视者健康眼这3个距离的调节滞后量分别为(0.40±0.14)、(0.29±0.09)、(0.17±0.06)D，与正常组主导眼差异无统计学意义；弱视治愈眼调节滞后量分别为(1.66±0.47)、(1.38±0.34)、(1.16±0.34)D，比相应距离弱视者健康眼大，差异有统计学意义(t=18.731、22.764、21.020，P均＜0.01)。弱视治愈眼在3个阅读距离调节反应的个体标准差分别为(0.09±0.04)、(0.09±0.02)、(0.09±0.02)D，弱视者健康眼3个距离个体标准差分别为(0.04±0.01)、(0.04±0.03)、（0.04±0.00）D，小于弱视治愈眼，差异均有统计学意义(t=10.072、10.216、22.342，P均＜0.01)。结论 弱视眼视力达正常后，与对侧健康眼和正常人眼比较，其调节反应滞后量较大，同时调节反应波动也相对较大，说明远视性屈光参差性弱视眼调节功能的康复滞后于视力的提高。%Objective To investigate the recovery of accommodative function in former amblyopes with monocular hyperopic anisometropia who had undergone successful orthoptic therapy.Methods In this cross-sectional study, 55 children with monocular hyperopic anisometropia who were former amblyopes and 50 emmetropes were investigated. A SRW-5500 autorefractor was used to measure accommodative response while the children viewed an E target placed at 50, 33 and 20 cm.Accommodative lags were calculated with formula accommodative demand minus accommodative refraction. Data were analyzed with an independent samples t test, a paired t test and a linear correlation analysis. Results At the 20, 33, 50 cm distance, the accommodative lags of the dominant eyes of the normal group were (0.26±0.31), (0.12±0.02) and (0.10±0.01)D, respectively, while the accommodative lags of the non-dominant eyes were (0.27±0.30), (0.17±0.14), and (0.12±0.01)D, respectively. The accommodative lags of the dominant eyes of the monocular former amblyopes at the 3 distances were (0.40±0.14), (0.29±0.09) and (0.17±0.06)D, respectively, and the accommodative lags of the non-dominant eyes were (1.66±0.47), (1.38±0.34) and (1.16±0.34)D, respectively. There was no significant difference in the accommodative lags of the dominant eyes between the former amblyopic and emmetropic groups at all reading distances. The accommodative lags of the non-dominant eyes in the former amblyopes were greater than those of the fellow eyes at the 3 distances. These overall differences were significant in the amblyopic subjects (t=18.731, 22.764, 21.020, P＜0.01). The standard deviations of accommodative responses for the former amblyopes with monocular hyperopic anisometropia were (0.09±0.04), (0.09±0.02), (0.09±0.02)D, respectively at the 3 distances, while those for the dominant eyes of the former amblyopes were (0.04±0.01), (0.04±0.03), (0.04±0.00)D,respectively. The standard deviations of the former amblyopic eyes were greater than those of the fellow eyes at the corresponding reading distance. These differences were significant (t=10.072,10.216, 22.342, P＜0.01). Conclusion The accommodative lags and variability of accommodative responses increase in former amblyopic eyes compare to the dominant fellow eyes and normal eyes in anisometropic subjects. This demonstrates that the recovery of accommodative function in hyperopic anisometropic amblyopes lags behind the improvement of visual acuity.
展开▼
