Ing Malcolm R
John A. Burns School of Medicine, University of Hawaii, Honolulu.
Trans Am Ophthalmol Soc. 2009 Dec;107:112-8.
There have been few reports on the binocular vision results in bilateral pseudophakic children. The author reports on the results of visual and binocular tests personally performed on patients who had the primary insertion of intraocular lenses following the removal of cataracts in their childhood.
The author visited 4 different medical centers to perform monocular and binocular tests on 21 patients using the same equipment for sensory testing for binocularity on all patients before the history was abstracted from the clinical records. These patients were selected from a consecutive series and followed up for a minimum of 5 years by their ocular surgeons.
The mean patient age at surgery performed on the first eye was 6 years 4 months. The mean age at the date of the author's examination was 16 years 5 months, and the mean length of follow-up was 10 years 4 months. All but 2 patients had motor alignment within 8 prism diopters of orthotropia at near. Fusion and some stereopsis were found to be present in 15 patients, but only 4 of these patients demonstrated fine (60 seconds of arc or better) stereoacuity. Patients with fine vs gross stereoacuity were compared and found to be similar in type of cataract, age at first surgery, interval between surgeries, and length of follow-up and refraction, but to differ in the quality of best-corrected visual acuity.
Although satisfactory motor alignment, fusion, and some stereopsis are present in the majority of patients, fine stereoacuity is uncommon in pseudophakic children.
关于双侧人工晶状体植入儿童双眼视觉结果的报道较少。本文作者报告了对童年期白内障摘除后首次植入人工晶状体的患者亲自进行的视力和双眼视功能测试结果。
作者走访了4个不同的医疗中心,使用相同的双眼感觉功能测试设备,对21例患者进行单眼和双眼测试,测试前从临床记录中提取病史。这些患者是从连续病例系列中挑选出来的,其眼科医生对他们进行了至少5年的随访。
第一眼手术时患者的平均年龄为6岁4个月。作者检查时的平均年龄为16岁5个月,平均随访时间为10年4个月。除2例患者外,所有患者近距离时的眼位运动斜度均在8棱镜度以内。15例患者存在融合和一定程度的立体视,但其中只有4例患者具有良好(60角秒或更好)的立体视锐度。对具有良好和粗略立体视锐度的患者进行比较,发现他们在白内障类型、首次手术年龄、手术间隔、随访时间和屈光度方面相似,但在最佳矫正视力质量方面存在差异。
尽管大多数患者存在令人满意的眼位运动、融合和一定程度的立体视,但人工晶状体植入儿童中良好的立体视锐度并不常见。