饼式后巩膜加固术治疗未成年人病理性近视的临床观察
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摘要
目的探讨未成年人病理性近视通过饼式后巩膜加固术治疗的临床效果。方法通过随机抽样法于本院2016年2月～2017年2月行饼式后巩膜加固术治疗的病理性近视未成年患者中选取20例(共30眼)作为实验组,于同期本院收治的非手术的病理性近视未成年患者中选取20例(共30眼)作为对照组,随访1年,对比两组视力、眼轴、屈光度改善情况。结果干预后,实验组裸眼视力、矫正视力均优于对照组,差异有统计学意义(P<0.05);干预后,实验组屈光度与干预前比较,差异无统计学意义(P>0.05),且实验组屈光度较对照组低,差异有统计学意义(P<0.05);干预后,实验组眼轴与干预前对比差异无统计学意义(P>0.05),且实验组眼轴长度小于对照组,差异有统计学意义(P<0.05),两组干预前后眼压差异无统计学意义(P>0.05);实验组患者均未出现严重并发症。结论未成年人病理性近视通过饼式后巩膜加固术治疗效果显著,可有效改善视力、屈光度,延缓眼轴增长,且不会对眼压造成明显影响,并发症少,值得选用。
Objective To investigate the clinical effect of cake-type posterior scleral reinforcement on pathological myopia in juveniles. Methods 20 juvenile myopia patients(30 eyes) who underwent the cake-type posterior scleral reinforcement from February 2016 to February 2017 were selected as the experimental group by the random sampling method.20 juvenile myopia patients(30 eyes in total) with pathological myopia who underwent non-surgical treatment were selected as the control group. The patients were followed up for 1 year. The improvement of visual acuity, axial length and diopter were compared between the two groups. Results After intervention, the naked visual acuity and corrected visual acuity of the experimental group were better than those of the control group, and the difference was statistically significant(P<0.05). There was no significant difference in the diopter of the experimental group before and after the intervention(P>0.05). The diopter of the experimental group was lower than that of the control group, and the difference was statistically significant(P<0.05). There was no significant difference between the experimental before and after intervention(P>0.05). The axial length of the experimental group was smaller than that of the control group, and the difference was statistically significant(P<0.05). There was no significant difference in intraocular pressure between the two groups before and after intervention(P>0.05). There were no serious complications in the experimental group. Conclusion The cake-type cake-type posterior scleral reinforcement in the treatment of pathological myopia of juveniles is effective,which can effectively improve vision, diopter, and delay the growth of the axial length, and will not have obvious impact on intraocular pressure, and is worthy of selection, with few complications.
Objective To investigate the clinical effect of cake-type posterior scleral reinforcement on pathological myopia in juveniles. Methods 20 juvenile myopia patients(30 eyes) who underwent the cake-type posterior scleral reinforcement from February 2016 to February 2017 were selected as the experimental group by the random sampling method.20 juvenile myopia patients(30 eyes in total) with pathological myopia who underwent non-surgical treatment were selected as the control group. The patients were followed up for 1 year. The improvement of visual acuity, axial length and diopter were compared between the two groups. Results After intervention, the naked visual acuity and corrected visual acuity of the experimental group were better than those of the control group, and the difference was statistically significant(P<0.05). There was no significant difference in the diopter of the experimental group before and after the intervention(P>0.05). The diopter of the experimental group was lower than that of the control group, and the difference was statistically significant(P<0.05). There was no significant difference between the experimental before and after intervention(P>0.05). The axial length of the experimental group was smaller than that of the control group, and the difference was statistically significant(P<0.05). There was no significant difference in intraocular pressure between the two groups before and after intervention(P>0.05). There were no serious complications in the experimental group. Conclusion The cake-type cake-type posterior scleral reinforcement in the treatment of pathological myopia of juveniles is effective,which can effectively improve vision, diopter, and delay the growth of the axial length, and will not have obvious impact on intraocular pressure, and is worthy of selection, with few complications.
引文
[1]孙国荣,陈忠飞,石秋梅,等.青少年近视进展与双眼视功能缺损关系研究[J].临床眼科杂志,2018,26(3):259-261.
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[6]袁建树,吴越,王育文.病理性近视脉络膜新生血管抗VEGF治疗期间黄斑中心凹下的脉络膜厚度变化[J].国际眼科杂志,2016,16(5):905-908.
[7]李倩,陈长征,苏钰,等.OCT血管成像术在病理性近视黄斑新生血管病变诊疗中的应用价值[J].中华实验眼科杂志,2016,34(12):1102-1106.
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[9]邹迎,张丰菊.巩膜胶原交联法在病理性近视中的研究新进展[J].中国实用眼科杂志,2016,34(9):913-916.
[10]刘维锋,赵雁之,李春英,等.高度近视眼后巩膜形态、黄斑轮廓形态临床观察[J].眼科新进展,2017,37(12):1158-1161.
[11]蔺琪,于刚,崔燕辉,等.改良四片式后巩膜加固术治疗儿童进行性高度近视临床研究[J].中国斜视与小儿眼科杂志,2016,24(3):27-28.
[12]袁梦克,高新晓,魏航,等.病理性近视黄斑劈裂的黄斑区脉络膜厚度及相关影响因素[J].中华眼视光学与视觉科学杂志,2016,18(9):542-545.
[13]林雯雯,叶成富.后巩膜加固术治疗病理性近视术后院内感染的控制及护理[J].中华全科医学,2017,15(5):893-895.
[14]王慧娟,秦虹.后巩膜加固联合玻璃体视网膜手术治疗病理性近视黄斑劈裂观察[J].中国实用眼科杂志,2017,35(2):204-206.
[15]许军,彭程,杨德琪,等.后巩膜加固术对病理性近视球后血管血流动力学及脉络膜厚度的影响[J].中华眼视光学与视觉科学杂志,2016,18(5):264-268.
[16]刘琼,淦强,叶波,等.后巩膜加固术治疗硅油填充术后复发性超高度近视黄斑裂孔性视网膜脱离[J].眼科新进展,2016,36(8):773-776.
[17]包芳军,黄丽芳,薛安全.后巩膜加固术的历史与现状[J].中华眼视光学与视觉科学杂志,2016,18(5):310-313.
[18]高婷婷,邴启斌,龙琴.后巩膜加固术研究新进展[J].临床眼科杂志,2017,25(4):381-383.
[19]张丁丁,伍敏婷.病理性近视患者心理状态分析与对策[J].中国现代医生,2009,47(19):49-50.
[20]王秀,何晴,路晓晓,等.后巩膜加固术治疗高度近视性视网膜病变的安全性和有效性分析[J].眼科新进展,2018,38(1):49-52.
[21]Yi S,Yi J,Yu S Z,et al.Clinical observation on posterior scleral reinforcement for pathological myopia in teenagers[J].International Eye Science,2016,16(4):732-734.
[22]张熙芳,乔利亚,李晓霞,等.病理性近视眼患者后巩膜加固术后视网膜及脉络膜厚度与血流改变的初步研究[J].中华眼科杂志,2017,53(1):39-45.
[2]Bing L,Li B,Zhang J.Optical coherence tomography angiography of pathological myopia sourced and idiopathic choroidal neovascularization with follow-up[J].Medicine,2016,95(14):3264-3266.
[3]占宗议,李梓敬,丁小燕.病理性近视继发脉络膜新生血管诊疗现状与进展[J].中华眼底病杂志,2016,32(1):104-107.
[4]易姝,易娟,余时智.后巩膜加固术治疗青少年病理性近视的疗效观察[J].国际眼科杂志,2016,16(4):732-734.
[5]李桂萍,侯跃双,夏改秀.梭形条带式后巩膜加固术治疗成年人病理性近视[J].国际眼科杂志,2017,17(1):184-186.
[6]袁建树,吴越,王育文.病理性近视脉络膜新生血管抗VEGF治疗期间黄斑中心凹下的脉络膜厚度变化[J].国际眼科杂志,2016,16(5):905-908.
[7]李倩,陈长征,苏钰,等.OCT血管成像术在病理性近视黄斑新生血管病变诊疗中的应用价值[J].中华实验眼科杂志,2016,34(12):1102-1106.
[8]Hu H,Zhao G,Wu R,et al.Axial length/corneal radius of curvature ratio assessment of posterior sclera reinforcement for pathologic myopia[J].Ophthalmologica,2017,239(23):128-132.
[9]邹迎,张丰菊.巩膜胶原交联法在病理性近视中的研究新进展[J].中国实用眼科杂志,2016,34(9):913-916.
[10]刘维锋,赵雁之,李春英,等.高度近视眼后巩膜形态、黄斑轮廓形态临床观察[J].眼科新进展,2017,37(12):1158-1161.
[11]蔺琪,于刚,崔燕辉,等.改良四片式后巩膜加固术治疗儿童进行性高度近视临床研究[J].中国斜视与小儿眼科杂志,2016,24(3):27-28.
[12]袁梦克,高新晓,魏航,等.病理性近视黄斑劈裂的黄斑区脉络膜厚度及相关影响因素[J].中华眼视光学与视觉科学杂志,2016,18(9):542-545.
[13]林雯雯,叶成富.后巩膜加固术治疗病理性近视术后院内感染的控制及护理[J].中华全科医学,2017,15(5):893-895.
[14]王慧娟,秦虹.后巩膜加固联合玻璃体视网膜手术治疗病理性近视黄斑劈裂观察[J].中国实用眼科杂志,2017,35(2):204-206.
[15]许军,彭程,杨德琪,等.后巩膜加固术对病理性近视球后血管血流动力学及脉络膜厚度的影响[J].中华眼视光学与视觉科学杂志,2016,18(5):264-268.
[16]刘琼,淦强,叶波,等.后巩膜加固术治疗硅油填充术后复发性超高度近视黄斑裂孔性视网膜脱离[J].眼科新进展,2016,36(8):773-776.
[17]包芳军,黄丽芳,薛安全.后巩膜加固术的历史与现状[J].中华眼视光学与视觉科学杂志,2016,18(5):310-313.
[18]高婷婷,邴启斌,龙琴.后巩膜加固术研究新进展[J].临床眼科杂志,2017,25(4):381-383.
[19]张丁丁,伍敏婷.病理性近视患者心理状态分析与对策[J].中国现代医生,2009,47(19):49-50.
[20]王秀,何晴,路晓晓,等.后巩膜加固术治疗高度近视性视网膜病变的安全性和有效性分析[J].眼科新进展,2018,38(1):49-52.
[21]Yi S,Yi J,Yu S Z,et al.Clinical observation on posterior scleral reinforcement for pathological myopia in teenagers[J].International Eye Science,2016,16(4):732-734.
[22]张熙芳,乔利亚,李晓霞,等.病理性近视眼患者后巩膜加固术后视网膜及脉络膜厚度与血流改变的初步研究[J].中华眼科杂志,2017,53(1):39-45.
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