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纸质出版:2015
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唐颖,叶剑.有晶体眼人工晶体植入术对高度近视眼双眼视功能的影响[J].陆军军医大学学报(原第三军医大学学报),2015,37(22):2289-2292.
Tang Ying,Ye Jian.Effect of implantable collamer lens on accommodation and nonstrabismic binocular anomalies in patients with high myopia: report of 30 cases[J].J Amry Med Univ (J Third Mil Med Univ),2015,37(22):2289-2292.
唐颖,叶剑.有晶体眼人工晶体植入术对高度近视眼双眼视功能的影响[J].陆军军医大学学报(原第三军医大学学报),2015,37(22):2289-2292. DOI:
Tang Ying,Ye Jian.Effect of implantable collamer lens on accommodation and nonstrabismic binocular anomalies in patients with high myopia: report of 30 cases[J].J Amry Med Univ (J Third Mil Med Univ),2015,37(22):2289-2292. DOI:
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 -10.00D to -20.00D (-16.25D in median)
and cylindrical power from 0 to -5.00D (-3.75D 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 anomalies. ICL can reduce the patients, myopic power and improve their binocular single vision. But it leads to accommodation deficiency
which may be associated with asthenopia symptoms after ICL implantation.
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