方法：选取我院于2010-01/2011-05期间收治的混合性散光弱视儿童163例289眼，所有患者均采用散瞳验光配镜联合弱视治疗，随访5a并观察患者5a内的弱视疗效和屈光状态变化。

结果：5a内患儿远视主径线屈光度逐年降低，其中第1a平均降幅为0.55DS，第2a平均降幅为0.56DS，第3a平均降幅为0.72DS，第4a平均降幅为0.95DS，第5a平均降幅为1.89DS； 患儿的等效球镜平均由远视1.12DS向近视0.78DS转变。所有患儿的初诊矫正视力均0.2～0.8，均存在不同程度的弱视。经过5a的戴镜治疗配合弱视训练后，有268眼(92.7%)有效，其中165眼(57.1%)进步，103眼(35.6%)基本痊愈，戴镜时间越长视力恢复效果越好。1.50～2.50DC组有36眼(37.5%)进步，60眼(62.5%)基本痊愈； 2.50～3.50DC组118眼(74.2%)进步，41眼(25.8%)基本痊愈； >3.50DC组11眼(32.3%)进步，2眼(5.9%)基本痊愈，21眼(61.8%)无效。各组之间疗效差异有统计学意义(均P<0.05)。

结论：正确的配镜是临床上治疗弱视的基础，散瞳验光配镜联合弱视治疗对大多数混合性散光弱视患儿都具有较好的临床疗效。

METHODS: Totally 163 children(289 eyes)of mixed astigmatism and amblyopia from January 2010 to May 2011 were treated. All of the patients received mydriatic optometry and spectaculars with amblyopia therapy and were followed up for 5a to observe amblyopia efficacy and refractive status changes.

RESULTS: With 5a, main diameter diopter at distant vision decreased year by year, average decline in the first year was 0.55DS, 0.56DS in the second year, 0.72DS in the third year, 0.95DS in the fourth year, 1.89DS in the fifth year. The spherical equivalent changed from 1.12DS at distant to 0.78DS at near. The corrected visual acuity of all the patients at first visit was 0.2-0.8 with varying degrees amblyopia. After a 5-year treatment, it was effective in 268 eyes(92.7%), in which 165 eyes(57.1%)improved, 103 eyes(35.6%)cured, the results was better as the period of spectaculars wearing was longer. There was 36 eyes(37.5%)improved and 60 eyes(62.5%)cured in 1.50-2.50DC group; 118 eyes(74.2%)improved, 41 eyes(25.8%)cured in 2.50-3.50DC group; 11 eyes(32.3%)improved, 2 eyes(5.9%)cured, 21 eyes(61.8%)useless in >3.50DC Group. The differences of efficacy among the groups were significant(all P<0.05).

CONCLUSION: Appropriate spectaculars is the basic for amblyopia treatment. It is effective for most children with mixed astigmatism and amblyopia to take mydriasis optometry and amblyopia treatment.