目的：探讨角膜塑形镜对间歇性外斜视合并近视患者眼表及视觉质量的影响。

方法：选取2017-01/2018-12我院收治的间歇性外斜视合并近视(等效球镜度数-0.75～-5.50D)患者60例120眼，随机分为治疗组和对照组，各30例60眼。治疗组和对照组患者分别在经三棱镜正位视训练干预的基础上配戴角膜塑形镜和框架眼镜，治疗时间至少持续6mo。分别于治疗前和治疗后6mo观察两组患者的斜视度、裸眼视力、最佳矫正视力、荧光素染色泪膜破裂时间(FBUT)、屈光度及视觉质量，并记录随访期间不良反应和并发症发生情况。

结果：两组患者治疗前各观察指标均无明显差异(P>0.05)，治疗后斜视度均减小，裸眼视力和最佳矫正视力均改善，FBUT均升高，视觉质量为优的患者比例均升高，且治疗组患者治疗后上述各观察指标及屈光状态均优于对照组(P<0.05)。 随访期间，两组患者眼眶和眶间疼痛、眼胀、头痛、睑结膜血管充血等不良反应和并发症总发生率无明显差异(13% vs 10%，P=1.000)。

结论：在三棱镜正位视训练治疗的基础上，配戴角膜塑形镜配戴有利于改善间歇性外斜合并近视患者眼表泪膜、屈光状态及视觉质量，且安全性良好。

METHODS: Totally 60 patients(120 eyes)with intermittent exotropia and spherical equivalent ranging from -0.75 to -5.50D were numbered and divided into study group and control group according to random number table, which included 30 cases(60 eyes)of patients in each group. Two groups patients were intervened by orthopaedic training with prism for at least half of a year. In addition, the study group matched the night wearing corneal plastic lenses through the standardization of corneal plastic matching process, and observed continuously for at least half of a year. The before and after treatment strabismus, naked eye vision, best corrected visual acuity, fluoresce-in staining tear film rupture time(FBUT), diopter and visual quality between the two groups were compared. The rate of adverse reactions and complications between the two groups was compared to evaluate the safety.

RESULTS: There was no significant difference in all before intervention indexes between the two groups(P > 0.05). Compared with that those of before intervention, in both groups, after treatment strabismus decreased, naked vision, best corrected vision and FBUT increased, diopter values reduced, and the proportion of patients with excellent visual quality increased. And the after treatment naked visual acuity, best corrected visual acuity, FBUT, diopter and visual quality in the study group were better than those in the control group(P<0.05). There was no significant difference in therate of adverse reactions and complications such as orbital and orbital pain, eye distention, headache, palpebral conjunctival vascular congestion between the two groups(13% vs 10%, P=1.000).

CONCLUSION: On the basis of triangular prism orthophotic training, the wearing of orthopaedic keratoplasty lenses can improve the tear film, refraction and visual quality of intermittent exotropia patients, and its safety is good, which is worthy of clinical application.