托吡卡胺与阿托品扩瞳验光结果对比研究

Comparative study of tropicamide and atropine in mydriatic refractometry

目的:了解5g/L托吡卡胺滴眼液与10g/L阿托品眼膏扩瞳对不同年龄阶段儿童验光结果的影响。方法:对212例疑屈光不正儿童先用5g/L托吡卡胺滴眼液扩瞳验光;待瞳孔恢复,再用10g/L阿托品眼膏扩瞳验光,比较两种扩瞳方法的结果。结果:远视组:球镜:相同5.6%,差异≥0.25DS者94.4%,柱镜:相同32.2%,差异≥0.25DC者67.8%,球、柱镜均以10g/L阿托品眼膏扩瞳高于5g/L托吡卡胺滴眼液扩瞳验光结果;各年龄组之间两两比较,具有显著统计学意义(P=0.000,P<0.01);近视组:球镜:相同者为10.7%,有不同程度的差异占89.3%;柱镜:相同者为26.7%,有不同程度的差异占73.3%,球、柱镜均以5g/L托吡卡胺滴眼液扩瞳高于10g/L阿托品眼膏扩瞳验光结果;混合散光组:球镜:33眼中有不同程度的差异占100.0%,以差异最大值为1.25DS,柱镜:33眼中两种扩瞳方法结果相同者40.0%,差异0.25～0.5DC者60.0%。结论:为确保验光结果的准确性,远视和混合散光12岁以内的儿童必须用10g/L阿托品眼膏扩瞳验光。

AIM.To compare the value of 5g/L tropicamide and 10g/L atropine in mydriatic refractometry for different age children. METHODS： Two hundred and twelve children with suspicious refractive errors were subjected to mydriatic refractomefry with 5g/L tropicamide mydriasis and 10g/L atropine mydriasis, and then the refractive results were compared. RESULTS： Among the hypermetropic eyes,5.6% presented identical spherical lens, while 94. 4% had more than 0.25DS difference after instillation of the two agents. There were 32. 2% in agreement with the degree of cylindrical lens while 67. 8% had more than 0. 25DC difference. In either spherical or cylindrical lens, 10g/L atropine revealed more hypermetropia than 5g/L tropicamide. There were statistically significant difference among different age grades. There were 10.7% and 26.7% myopia eyes in agreement with the degree of spherical and cylindrical lens respectively. In either spherical or cylindrical lens, 10g/L atropine revealed more hypermetropia than 5g/L tropicamide. Among 33 mixed astigmatism eyes, 100.0% presented different degrees of spherical lens. The biggest difference was 1. 25DS. While 40. 0% （33 eyes） presented identical cylindrical lens degrees. 60.0% eyes had 0.25-0.5DC difference. CONCLUSION; Atropine is an imperative cycloplegic agent for mydriatic refractometry in less than 12 years old children with hypermetropia and mixed astigmatism. ;