Stereopsis and binocular vision after surgery for unilateral infantile cataract
Stereopsis and binocular vision after surgery for unilateral infantile cataract
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DOI：
10.1016/s1091-8531(99)70080-7
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发表时间：
1999-04-01
期刊：
影响因子：
1.6
通讯作者：
Del Monte, MA
中科院分区：
文献类型：
--
作者：
Brown, SM;Archer, S;Del Monte, MA
目的：探讨单侧先天性或婴幼儿早期白内障的患病率及双眼功能水平。方法：我们回顾性地回顾了1985年至1995年在W. K. Kellogg眼科中心/密歇根大学医院4个月前接受手术的所有单侧先天性或极早期婴儿白内障患者的病历。弱视在出生后的前6个月采用减少的配片计划，即每天1小时，在假定的双眼皮质通路发育的关键时期允许更多的双眼相互作用时间，以改善双眼功能。结果：13例患者符合纳入标准。7例为持续性增殖性原发性玻璃体白内障，6例为非玻璃体白内障。总体而言，69%的患者视力达到20/80或更好；100%的非phpv白内障患者的视力达到20/60或更好。在62%的患者中检测到400秒或更高的立体视，其中包括3名患有PHPV白内障的患者和3名在出生后一年内需要斜视手术的患者。三个孩子有超过150秒的立体视觉。大角度斜视的发生率为54%。结论：婴儿白内障早期摘除后，单侧无晶状体患儿的双眼合作功能，包括粗大立体视觉和精细立体视觉的发展。一个比以往提倡的不那么费力的贴片计划可能会促进这一过程，同时恢复和保持良好的中央视力，使患者非常遵守隐形眼镜和遮挡方案。
Purpose:To assess the prevalence and level of binocular function in children with unilateral congenital or very early infantile cataract. Methods:We retrospectively reviewed the charts of all patients with unilateral congenital or very early infantile cataract who underwent operation before 4 months of age, at the W. K. Kellogg Eye Center/University of Michigan Hospitals, from 1985 to 1995. Amblyopia was treated with a reduced patching schedule consisting of 1 hour per day per month of age for the first 6 months of life, in an attempt to improve binocular function by allowing more hours of binocular interaction during the presumed critical period for development of binocular cortical pathways. Results: Thirteen patients met the inclusion criteria. Seven patients had persistent hyperplastic primary vitreous (PHPV) cataract and 6 had non-PHPV cataract. Overall, visual acuity of 20/80 or better developed in 69% of patients; 100% of eyes with non-PHPV cataract achieved Visual acuity of 20/60 or better. Stereopsis of 400 are seconds or better was detectable in 62% of patients, including 3 with PHPV cataract and 3 who required strabismus surgery in the first year of life. Three children had better than 150 are seconds of stereopsis. The incidence of large-angle strabismus was 54%. Conclusions: Binocular cooperation, including gross and fine stereopsis, can develop in children with unilateral aphakia as a result of early removal of infantile cataracts. A less-strenuous patching schedule than has been historically advocated may foster this process, while restoring and maintaining good central visual acuity in patients with excellent compliance with contact lens and occlusion regimens.