| BackgroudChildren with cataract is a common disease in children,its pathogenesis divides into inherited and acquired.Acquired factor generally caused by trama.Congenital cataract dues to genetic or come into after birth or developmental disorders of lens opacity,it is an important cause of blindness and amblyopia in children.Its incidence in China is 0.5%~1.5%, the pathogenesis can be divided into genetic factors, environmental factors or other unknown reasons.As children road is not clear,the macular area of optic nerve cells failed to get external light stimulation and stunted or stagnant, resulting in low visual acuity and visual impairment caused by amblyopia. Thus, congenital cataract in children with early surgery should be considered, to keep the road open, however perfect The operation and cannot completely solve the problem of children with critical postoperative amblyopia training. There is a sensitive period of visual development of children, usually between 4 months after birth to 10 years of age, children with treatment at this stage for amblyopia training significantly, more than 10 years old children with very little training effect. So with intraocular lens implantation after surgery, amblyopia training should be done as early as possible. Amblyopia training is an arduous and difficult task, it needs to be full of confidence, the children and their parents faith, persevere in order to obtain good results. Traditional treatment methods mainly cover therapy, refractive correction, atropine therapy, red light flash instrument, sea brush, afterimage therapy and drug therapy, long time application of these methods in the treatment of children feel boring, rote, inability to concentrate training, poor compliance, in the course of time, visual acuity in children with stagnation, parents of children gradually lose confidence the treatment, give up halfway. With the development of the Internet, a new type of amblyopia treatment technology came into being, which is the four dimensional digital oblique amblyopia visual function correction system, it mainly includes three sub-systems: fine stimulation function training, perception fusion function training and three-dimensional vision training In practice, it needs the children’s eyes, son, mouth, hands, and brain, it is a set of visual, auditory and tactile multimedia technology as a whole, with training increased interest, compliance is greatly improved, it gets the parents and ophthalmologists’ consistent high praise. PurposeTo observe the effect of congenital cataract extraction and intraocular lens implantation in children with amblyopia training system for using the four dimensional digital oblique amblyopia visual function correction treatment, to explore different age children with congenital cataract intraocular lens implantation operation after the visual function recovery, and explore the best method and opportunity of amblyopia in children with amblyopia training. MethodsA retrospective analysis methods to collect the clinical data of 150 cases(239 eyes)of congenital cataract implanted intraocular lens postoperative children, and amblyopia training, according to the different training methods, were randomly divided into for using four dimensional digital oblique amblyopia visual function correction 72 cases(122 eyes), traditional amblyopia treatment group(78 cases) 117 eyes, respectively, to observe the amblyopia training after 3 months and 6 months with naked eye vision, corrected visual acuity, visual evoked potentials P100 latency and N75-P100 amplitude change and triple visual function recovery. Corrected visual acuity reached 0.6 children with both eyes, the eyes triple visual function training, Compare the two groups of near and far stereo vision recovery. Results1. Comparison of curative effect of two groups of amblyopia training: the total efficiency with the group of four dimensional digital was 95.8%, and the traditional treatment group was 74.3%, the efficiency of the two groups had significant difference(c2=10.31, P=0.005).2. The efficiency of two groups in different age stages of amblyopia therapeutic effect : compared 3 to 4 years and 5 to 6 age group, two groups of difference was statistically significant(P=0.097,P=0.000), 7-8 years old group and 9 ~ 10 years old group, the difference between the two groups no significant(P=0.061,P=0.063).3. Compared two groups of different degree of amblyopia amblyopia training: mild amblyopia group and severe amblyopia group, comparing the two groups has statistical significance( P=0.002, P=0.012), and the differences of moderate amblyopia group between the two groups was not statistically significant(P=0.084).4. Comparison of the levels of evoked potentials in the two groups before and after amblyopia training: two groups of training P100 latency compared with those before training have shortened,the amplitude of the N75-P100 as compared with those before training increased. The mean level variation of the P100 latency and N75- P100 amplitude after 6 mouths’ training is more obvious.After 3 months of training average level of P100 latencies of both groups were respectively(95.80±9.92) ms,(102.6± 67.34 ms), the difference between the two groups has statistical significance(Z=20.31,P=0.000), the average of two groups of N75-P100 amplitude respectively for(25.78±4.78) mv,(22.35±7.45) mv, the difference between the two groups has statistical significance(Z=10.85, P=0.001). After 6 months’ training, the average level of P100 latencies of both groups were respectively( 87.95 ± 7.64) ms,(92.45± 8.98)ms, the difference is statistically significant(Z=12.09, P=0.000), the average level of N75-P100 amplitude of both groups were( 27.63 ± 6.81) mv,(23.08± 6.53)mv, the difference was statistically significant(Z=13.74, P=0.000).5. Comparison of the recovery of stereoscopic vision after two groups of amblyopia training: corrected visual acuity was above 0.6, after training in two groups, there are 40 eyes of far stereopsis in the group of four dimensional digital, accounting for 68.9%. near stereoacuity basic in the normal range with 34 eyes, accounting for 58.6%. There are 15 eyes of far stereopsis in the group of conventional treatment, ccounting for 37.5%, near stereoacuity normal has 6 eyes, accounting for 15.0%, two groups of far stereopsis and near stereopsis percentage compared, the differences were statistically significant(P=0.002, P=0.000). Conclusion1. Four dimensional digital oblique amblyopia visual function correction system is better than the traditional amblyopia training in children with amblyopia treatment effect, it is an effective treatment for amblyopia, It has obvious advantages in improving the visual acuity of children with moderate and severe amblyopia.2. Amblyopia treatment of younger, better treatment.3. Implantation of the intraocular lens after 2 weeks,if the children timely take refractive correction, regular, outpatient review, good compliance, they can get good resultsge.4. After the treatment of amblyopia, the level of visual evoked potential returns to normal.5. The use of four demensional digital oblique amblyopia visual function correction system for amblyopia training, so that the children’s visual acuity improves at the same time, the reconstruction of the three level visual function has a significant advantage. |
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