北京市顺义区3~6岁儿童睫状肌麻痹前后屈光状态的变化

Changes of Refraction before and after Cycloplegia in 3 to 6 Year-Old Children in Shunyi District,Beijing

目的:探讨北京市顺义区学龄前儿童睫状肌麻痹前后屈光状态的变化。方法:横断面研究。于2020年9月至2021年5月采用随机整群分层抽样的方法,对北京市顺义区11所幼儿园的3~6岁儿童1186例在1%盐酸环喷托酯麻痹睫状肌前后进行电脑验光,计算等效球镜度(SE)。采用Thibos矢量分析法将散光分解为J_(0)和J_(45)成分,比较不同年龄、屈光状态儿童睫状肌麻痹前后的SE和散光结果,各屈光成分睫状肌麻痹前后的差异比较采用t检验,各屈光成分睫状肌麻痹前后的变化值在不同年龄、屈光状态的差异比较采用方差分析,睫状肌麻痹前后不同散光类型分布的差异比较使用卡方检验。结果:共1142例儿童完成检查,年龄为(4.5±0.9)岁,睫状肌麻痹后3~6岁儿童SE漂移为(1.06±0.81)D,睫状肌麻痹后总散光的变化很小,J_(0)在不同状态下均增加,J_(45)保持不变。3~6岁儿童睫状肌麻痹前后均主要为顺规散光,其次为斜轴散光和单纯近视或远视,逆规散光最少。结论:睫状肌麻痹后3~6岁儿童的SE会发生显著的远视漂移,散光量和散光轴向虽然也发生了一定变化,但变化很小。

Objective:To investigate the changes of refraction before and after cycloplegia in preschool children in Shunyi District,Beijing.Methods:This was a cross-sectional study.Random cluster stratified sampling method was used to select 1186 children aged 3-6 years from 11 kindergartens in Shunyi District,Beijing from September 2020 to May 2021.Computer optometry was performed before and after cycloplegia using 1%cyclopentolate,and spherical equivalent(SE)was calculated.Astigmatism were decomposed into J_(0)and J_(45)components through Thibos vector analysis,and the SE and astigmatism before and after cycloplegia was compared in children of different ages and refraction.The difference of refraction components before and after cycloplegia was analyzed using t-test.The changes of each refractive component before and after cycloplegia in different groups were analyzed using variance analysis.The distribution of astigmatism types before and after cycloplegia was analyzed using Chi-square test.Results:In this study,totally 1142 children aged 4.5±0.9 years completed the examination.The mean SE drift of children aged 3-6 years after cycloplegia was 1.06±0.81 D.The total astigmatism changed little after cycloplegia.J_(0)increased in different groups,while J_(45)remained unchanged.Astigmatism before and after cycloplegia in children aged 3-6 years,was mainly with-the-rule,followed by oblique astigmatism,no astigmatism,and against-the-rule.Conclusions:After cycloplegia,the SE of children aged 3-6 years will experience a significant drift towards.Although there are also some changes in the amount and axis of astigmatism,these changes are minimal.