Współczesne metody wyrównywania krótkowzroczności
Current Methods of Myopia Correction and Treatment
Tomasz Wilczyński, Bogumiła Wójcik-Niklewska, Maria Formińska-Kapuścik, Aleksandra Zielińska, Ewa Pieczara
Klinika Okulistyki Dziecięcej Katedra Okulistyki Śląskiego Uniwersytetu Medycznego Samodzielny Publiczny Szpital Kliniczny nr 5 Śląskiego Uniwersytetu Medycznego w Katowicach Kierownik: prof. dr hab. n. med. Maria Formińska-Kapuścik
Summary: Aim: Discussion on current methods of correction and treatment of myopia in children with particular attention to surgical methods and indications for their use. Methods: Review of recent literature, both in English or Polish, found in MEDLINE and PubMed, which deals with the topic. Results: Spectacles as well as soft contact lenses, which are prescribed more and more willingly, remain a golden standard for myopia treatment. Progressive vision lenses do not have any proven advantage over monofocal lenses. Hard contact lenses are associated with many side effects particularly infectious. Methods of refractive surgery, which have been applied in the treatment of children so far, are PRK, LASIK, LASEK, clear lens extraction with or without IOL implantation, phacic intraocular lenses. There are no large, multicenter trials assessing refractive surgery and referring to golden standards of treatment or comprising the methods. Today it seems that the indications for surgery are the same as for contact lenses ? anisometropia over 2.0-2.5 Dsph, high myopia ? in children with neurobehavioral disorders or when contact lenses intolerance emerged. Pharmacological inhibition of myopia progression is still under investigation, there are equivocal results for its efficacy. Conclusions: No means of correction or treatment are proven to inhibit vision defect progress. Limitation for close work is proposed based on the theoretical models. Spectacles remain a golden standard, as well as soft contact lenses, especially in cases where prevention of amblyopia due to anisometropia in crucial. There are no standards of surgery implementation, each case have to be considered individually.
Słowa kluczowe: krótkowzroczność, soczewki kontaktowe, ortokeratologia, różnowzroczność, chirurgia refrakcyjna.
Keywords: myopia, contact lenses, orthokeratology, anisometropia, refractive surgery.