摘要目的 研究在睫状肌麻痹状态下不同程度的屈光矫正对远视性弱视儿童眼球正视化过程的影响.方法 选取3～6岁远视度在3.00DS～9.00DS屈光不正性弱视儿童200例(336眼),阿托品散瞳检影验光,散瞳状态下给予配镜,配镜处方甲组(60例,108眼)给予检影验光度数的3/4,乙组(72例,116眼)给予检影验光度数的2/3,丙组(68例,112眼)给予检影验光度数的1/2,每半年重新散瞳检影验光,按原方法配镜,连续观察3年屈光状态、视力、眼轴变化.结果 各组患儿的远视屈光度均逐年减少,平均每年递减度数乙组(+0.50±0.20)DS和丙组(+0.55±0.25)DS明显高于甲组(+0.31±0.21DS)(P<0.01),丙组(68例,112眼)和乙组的平均每年递减度数相比均差异无显著性(P>0.055);各组患儿的眼轴也逐年增长,平均每年递增轴长丙组(0.25±0.07)mm高于甲组(0.21±0.04)mm和乙组(0.22±0.06)mm(P<0.05),甲组和乙组的平均每年递增轴长相比差异无显著性(P>0.05),弱视治愈时间相比丙组(19.42±6.35)月长于甲组(17.76±5.48)月和乙组(17.31±5.13)月(P<0.05),甲组和乙组相比差异无显著性(P>0.05).结论 不同程度屈光矫正对远视性弱视儿童屈光状态及其正视化过程有影响,予保留其1/3的远视性光学离焦,有利于患眼的正视化;保留过多的远视性光学离焦不利于患儿的弱视治疗且散瞳状态下给予配镜可提高患儿戴镜依从性.

abstractsObjective To study the influence of different refractive correction on the emmetropization of child hyperopia amblyopia under ciliary muscle paralysis. Methods 200 3-6-yearold ametropic amblyopia patients (336 eyes) (hyperopia degree +3.00DS ～ +9.00DS) were examined through optometry with mydriatic cycloplegic. Prescription of spectacles after mydriatic were given. The prescription of spectacles for group 1 equals to 3/4 of the diopter of retinoscopy, while group 2 equals to 2/3 of it and 1/2 for group 3. Redo the optometry with mydriatic cycloplegic every half year, and give prescription of spectacles with the same way. The changes of diopter, eyesight, and axial length were continuously observed for 3 years. Results All groups' hyperopia diopter have decreased by year,however, group 2 and 3 were significantly higher than those of group 1 (P<0.0 1). No remarkable difference between group 2 and 3 (P>0.05) were found. And the average increment of axial length of group 3 was higher than those of other two groups (P<0.05). There was no remarkable difference between group 1 and 2. The curing time of amblyopia of group 3 was longer than those of other two groups (P<0.05). There was no remarkable difference between group 1 and 2 (P>0.05). Conclusion Refractive correction of different degree have impact on emmetropization of children with hyperopia amblyopia. According to refractive situation, reserving 1/3 of hyperopic optical defocus helps the patients' emmetropization, while too much brings negative effect on amblyopia treatment. And prescription of spectacles after mydriatic can improve patients' compliance to spectacles.