Early binocular visual experience may improve binocular sensory outcomes in children after surgery for congenital unilateral cataract
Early binocular visual experience may improve binocular sensory outcomes in children after surgery for congenital unilateral cataract
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DOI：
10.1067/mpa.2001.115591
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发表时间：
2001-08-01
期刊：
影响因子：
1.6
通讯作者：
Weakley, DR
中科院分区：
文献类型：
--
作者：
Jeffrey, BG;Birch, EE;Weakley, DR
目的：比较强化和减少遮挡治疗方案对先天性单侧白内障术后儿童双眼感觉结局、视力和斜视患病率的影响。方法：前瞻性研究了两个非随机分组的患者：（1）强化闭塞组（n = 29），在清醒时间的80%贴敷贴片，中位随访时间为6.9年;（2）减少闭塞组（n = 8），在清醒时间的25%至50%贴敷贴片，中位随访时间为4.3年。强化组中的6名受试者和减少闭塞组中的4名受试者植入了二期人工晶状体。强化组中的2例受试者接受了表层角膜镜片手术。双眼感觉功能用随机点和轮廓立体视锐度测试和Worth 4点测试进行评估。斜视的患病率和发病年龄从患者的病历中确定。结果与密集闭塞组（14%）相比，减少闭塞组（50%）中具有立体视或融合的受试者比例更高，存在边缘显著性差异（P= 0.08）。密集（20/50）和减少遮挡（20/55）组之间的中位视力无显著差异（P= 0.55）。高度闭合组斜视患病率为90%，略高于低度闭合组的63%，但差异不显著（P= 0.18）。结论：这些结果表明，减少阻塞协议可能与更好的双眼感觉的结果和斜视的患病率降低，而不影响良好的视力治疗先天性单侧白内障的儿童。
Purpose: To compare the effect of intensive and reduced occlusion therapy regimens on binocular sensory outcomes, visual acuity, and the prevalence of strabismus in children after surgery for congenital unilateral cataract. Methods:Two nonrandomized groups of patients were studied prospectively: (1) an intensive occlusion group (n = 29) patched 80% of waking hours were followed for a median 6.9 years and (2) a reduced occlusion group (n = 8) patched 25% to 50% of waking hours were followed for a median 4.3 years. Six subjects in the intensive group and 4 in the reduced occlusion group had secondary intraocular lenses. Two subjects in the intensive group had epikeratophakia surgery. Binocular sensory function was assessed with random dot and contour stereoacuity tests and the Worth 4-dot test. The prevalence and age at onset of strabismus were determined from the patients' charts. Results. A higher proportion of subjects in the reduced occlusion group (50%) had stereoacuity or fusion compared with the intensive occlusion group (14%), a borderline significant difference (P=.08). No significant difference (P=.55) was found in median visual acuity between the intensive (20/50) and the reduced occlusion (20/55) groups. The 90% prevalence of strabismus in the intensive occlusion group was slightly higher than the 63% prevalence in the reduced occlusion group, although this difference was not significant (P=.18). Conclusions: These results suggest that a reduced occlusion protocol may be associated with better binocular sensory outcomes and a reduced prevalence of strabismus without compromising good visual acuity in children treated for congenital unilateral cataract.