摘要
目的观察不同睫状肌麻痹剂对小学一年级学生屈光状态的影响,并监测相关生物参数变化,为青少年眼保健提供基础保健预防数据。方法对小学一年级学生377人动态眼屈光状态等指标进行采集,同时进行1%阿托品点眼3 d、0.5%托品酰胺点眼1 d验光,和眼轴、眼压、身高、体重测量,输入专用数据库,SPSS12.0软件统计分析。结果 (1)屈光状态:377人的近视检出率为48.1%,其中低度近视占41.1%,正视眼占45.5%,远视眼6.4%。动态平均屈光度(等效球镜,SE)为(-0.83±1.45)D,女生(-0.96±1.57)D,男生(-0.70±1.27)D,右眼(-0.83±1.45)D,左眼(-0.81±1.39)D(P)。右眼球镜(-0.44±0.74)D、柱镜(-0.61±1.37)D,左眼球镜(-0.46±0.74)D、柱镜(-0.58±1.34)D,女生球镜(-0.71±1.50)D、柱镜(-0.49±0.80)D,男生球镜(-0.50±1.21)D、柱镜(-0.41±0.69)D(P=0.030)。平均散光-0.45 D,分布于+1 D～-3 D。(2)晶状体调节:以动态屈光度为比较基准,35人阿托品点眼3 d后,平均屈光度改变+0.56 D,63人托品酰胺点眼1 d后,改变+0.22D,31人托品酰胺联合阿托品点眼3 d,平均屈光度改变+0.81 D。以用药后屈光度为比较基准,42人阿托品点眼24 d后,平均屈光度改变-0.38 D,21人托品酰胺点眼2 d后,改变-0.48 D。(3)相关眼生物参数:A超测量81人,眼轴22.76 mm时,平均屈光度+0.41 D;其中,右眼眼轴22.84 mm时,屈光度0.27 D,左眼眼轴22.68 mm时,屈光度+0.55 D;平均角膜厚度右眼535μ、左眼530μ,平均眼压右左眼均为16 mm Hg。(4)多元逐步回归分析:屈光度的变化与眼轴、眼压呈负相关。多元回归方程:屈光度(y)=83.731-2.1眼轴-0.809曲率-0.187眼压+1.095前房深度。结论 (1)儿童眼球发育已经在7岁提前进入近视化状态。(2)睫状肌麻痹剂对调节性近视的影响以托品酰胺联合阿托品最强,但晶体的调节作用对儿童屈光变化的影响较小。(3)儿童近视性质为伴以眼轴过长、远视缓冲基本消失、眼球过度发育的轴性近视,并且�
Objective To observe the influence on the dynamic refractive status with different cyeloplegies in the first year students of primary school, and the related ocular biological parameters. Methods The objective ophthalmic examlnatinns were done by special trained ophthalmologists and nurses for all 377 kids, including non-eycloplegic objective refraction, visual acuity, intraocular pressure, fundus evaluation, and axial length measurement. The subjective refraction was done after 1% Atropine and 0.5% Tropicamid were applied 3 days and 1day respectively. The special designed sheet was filled in and input special computer programs, then the data were statistically analyzed with SPSS12.0. Results 1. Un- der the dynamic refractive status with non-cycloplegic objective refraction, the detective rate of myopia was 48.1%, inclu- ding low myopia 41.1%, moderate myopia 6.1%, high myopia 0.9%, emmetropia 45.5% only, and hypermetropia 6. 4%. The average diopter of spherical equivalent refraction was （ -0. 83 ± 1.45 ） D; The degrees of myopia in girls which was （ - 0.96 ± 1.57 ） D was significantly higher than in boys , （ - 0.70 ± 1.27） D and right eyes, （ - 0.83 ± 1.45 ） D was higher than left eyes , （ -0.81 ± 1.39 ） D , but with no significance. The average cylinder was （ -0. 61 ± 1.37 ） D with sphere （ - 0.44 ± 0.74 ） D in right eye, the average cylinder - （0.58 ±1.34 ） D with sphere （ - 0.46 ± 0. 74 D ） in left eye. The average cylinder was （ - 0.49± 0.80 ） D with sphere （ - 0.71 ± 1.50 ） D in girl , the average cylinder （ - 0.41 ±0.69 ） D with sphere （ -0.50 ± 1.21 ） D in boy. which was higher in right eye and 8irl than in left eye and bey （ P = 0.030）. 2. Compared with the non - cyeloplegie objective refraction, average diopter was reduced by ＋0.56 D with 1% Atropine in 35 kids, by ＋0.22 D with 0.5% Tropicamid in63 kids, by ＋0.81 D with combined 1% Atropine and0.5% Tropicamid. Compared with the eycloplegie subjective refraction, the refraction wa
出处
《临床眼科杂志》
2012年第5期399-405,共7页
Journal of Clinical Ophthalmology
基金
陕西省科技厅科技研究发展项目(编号2009K17-02)
安徽省科技厅科技研究发展项目(编号2008B086)
西安市科技局社会发展基金资助项目(编号GG2006156)
关键词
小学一年级学生
等效球镜
近视化
眼生物参数
眼轴
眼压
First year student of primary school
Spherical equivalent refraction myopizattion
Ocular biological pa-rameters
Ocular axial length intmocular pressure
