摘要
目的比较分析高度近视眼行有晶体眼人工晶体植入术(implantable collamer lens,ICL)前后调节和非斜视性双眼视异常类型的变化。方法选取30例准备进行ICL手术的高度近视患者,年龄20~35岁(中位数28岁),球镜-10.00D^-20.00D(中位数-16.25D),柱镜0~5.00D(中位数-3.75D)。分别于术前及术后1、3、6个月进行双眼视功能的检查,包括远距离水平隐斜(distant lateral phoria,DLP)、近距离水平隐斜(near lateral phoria,NLP)、远距正融像性集合(distant positive fusion vergence,DPFV)、远距负融像性集合(distant negative fusion vergence,DNFV)、近距正融像性集合(near positive fusion vergence,NPFV)、近距负融像性集合(near negative fusion vergence,NNFV)、调节性集合与调节比值(accommodative convergence/accommodation,AC/A)、调节灵活度(accommodation of facility,AF)、交叉柱镜法测量调节反应(binocular Cross-cylinder,BCC)、正负相对调节(positive relative accommodation/negative relative accommodation,NRA/PRA)、调节幅度(amplitude of accommodation,AMP),诊断调节和非斜视性双眼视异常类型。所有检查均在验光后最佳矫正视力下进行,视标采用最佳矫正视力的上一行或单个视标。结果 30例患者中术前存在间断性单眼抑制18例,间断性复视4例,22例(73.33%)没有稳定的双眼单视,术后无1例患者存在抑制或复视,30例患者术后均获得稳定的双眼单视(100%);术前调节异常8例(26.67%),非斜视性双眼视异常22例(73.33%),术后调节异常29例(96.67%),仅1例(3.33%)存在集合不足型外隐斜。结论高度近视患者存在不同类型不同程度的调节和非斜视性双眼视异常。ICL手术在使其屈光状态恢复正视的同时,其双眼单视功能得到绝大部分改善,但调节不足显著增加,可能跟术后视疲劳症状有关。
Objective To compare the types of accommodation and nonstrabismic binocular anomalies before and after implantable collamer lens（ ICL） implantation in the patients with high myopia.Methods Thirty patients with high myopia,at an age of 20-35（ 28 in median）,were selected for ICL implantation in our department from September 2014 to February 2015,and they had spherical power from-10. 00 D to-20. 00D（-16. 25 D in median）,and cylindrical power from 0 to-5. 00D（-3. 75 D in median）. Before ICL implantation and in the 1st,3rd,and 6th months after ICL implantation,binocular visual functions were examined under the best corrected visual acuity with the test object at the previous line,including distant lateral phoria（ DLP）,near lateral phoria（ NLP）,distant positive fusion vergence（ DPFV）,distant negative fusion vergence（ DNFV）,near positive fusion vergence（ NPFV）,near negative fusion vergence（ NNFV）,accommodative convergence / accommodation（ AC / A）,accommodation of facility（ AF）,binocular cross-cylinder（ BCC）, positive relative accommodation / negative relative accommodation（ NRA/PRA）,and amplitude of accommodation（ AMP）. The types of accommodation and nonstrabismic binocular anomalies were analyzed in different periods. Results Before ICL implantation,22（ 73. 33%）patients were free from binocular single vision. Specifically,there were 18（ 60%） patients with monocular suppression and 4（ 13. 3%） with diplopia. After ICL implantation,there was no suppression or diplopia,and all the patients showed stable binocular single vision. Before ICL implantation,8 patients（ 26. 67%） had accommodative dysfunctions and 22 patients（ 73. 33%） had binocular dysfunctions. After ICL implantation,29（ 96. 67%） patients had accommodative insufficiency, and only one（ 3. 33%） had convergence insufficiency and accommodative insufficiency. Conclusion The patients with high myopia have different types and degrees of accommodation and nonstrabismic binocular anom
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2015年第22期2289-2292,共4页
Journal of Third Military Medical University
关键词
ICL
高度近视
双眼视
调节和非斜视性双眼视异常
implantable collamer lens
high myopia
binocular vision function
accommodation and nonstrabismic binocular anomalies
