不同睫状肌麻痹剂对儿童调节力及屈光状态的影响

The effect of accommodation and refractive status on children after three kinds ofcycloplegia

目的找出美多丽P滴眼液、罗米滴眼液最大睫状肌麻痹时间，对比美多丽P滴眼液、罗米滴眼液、1％阿托品眼膏最大睫状肌麻痹时的剩余调节力，并分析3种药物对屈光不正检测的影响。为眼科临床上合理应用睫状肌麻痹剂提供一定的实验依据。方法对4～16岁儿童75例、147只眼进行检查，均未曾配戴眼镜，未曾屈光治疗，其裸眼或矫正视力均可达1．0，并除外其他眼病及影响调节的全身病。按3种药物分3组，对其睫状肌麻痹前后不同时间点分别进行手持自动电脑验光仪客观验光，视网膜检影验光，在综合验光仪上主观验光，在其上用移近法测量调节力及剩余调节力。结果（1）最大睫状肌麻痹时间罗米为60min，美多丽P为30min，次日均可以正常阅读。（2）最大睫状肌麻痹时平均剩余调节力：1％阿托品组（2．0440±0．95484）D，罗米组（2．2214±0．6952）D，美多丽P组（2．6656±0．9999）D。两独立样本t检验前两组无显著差异，美多丽P组与前两组差异显著，尤其近视时剩余调节力偏大。（3）三组剩余调节力均与屈光状态及年龄无关。（4）1％阿托品、罗米、美多丽P三组中每组药物最大睫状肌麻痹后，综合验光仪验光、视网膜检影结果无差别，都能达到主、客观验光结果的一致性。结论罗米滴眼液、美多丽P滴眼液在临床上可以作为近视及远视验光的有效睫状肌麻痹剂。

Objective To find out the longest effective duration of Mydrin P and Romi eyedrop on cycloplegia, compare the residual accommodation after cycloplegia by Mydrin P eyedrop, 1% Atropine paste and Romi eyedrop, analyze their effect on ametropia. To provide some experimental basis for using cycloplegia adeptly in clinic. Methods Seventy-five children （147eyes） were checked,4-16 years old with,mean age of 10.12 years old. There are no systemic diseases. The patients were divided into 3 groups： A, 1% Atropine group; B, Romi eyedrop group and C, Mydrin P group. Before and after administration of these eyedrops, objective refraction was checked in hand-hold auto refractor; subjective refraction was checked in phoropter, and retinoseopy refraction was finished. Phoropter was used to check the accommodation response and the residual accommodation respectively by ＂pushup＂ method. Results （ 1 ） In Romi eyedrop group, the time of maximum cycloplegia was 60 minutes,the patients can read in the next day; in Mydrin P group,the time was 30 minutes, can read next day. （2） Average residual accommodation at the maximum cycloplegia： A, 1% Atropine group （2.0440＋ 0.95484D）,B,Romi eyedrop group （2.2214±0.6952D）,C,Mydrin P group （2.6656±0.9999D）. The residual accommodation in Romi eyedrop and Atropine groups had no significant difference ,Independent-samples t Test P 〉0.05.The residual accommodation in Mydrin P group was stronger than the other two groups, more significant in myopia eyes. （3） The residual accommodation of three groups had no relationship with age and refractive status. （4） The results were same in cyeloplegie refraction with hand-hold auto refractor and phoropter of each group of A,l% Atropine group,B,Romi eyedrop group and C,Mydrin P group （P 〉0.05）. The difference was 0.33D in autorefraction and phoropter,autorefraction negative. Conclusions （1） The time of maximum cycloplegia effective of Romi eye-drop was 60 minutes, of Mydrin P was 30 minutes. （2） The residual accommodation in Romi eyedrop and Atropine groups was almost same, the residual accommodation in Mydrin-P group was stronger than the other two groups, more significant in myopia eyes. （ 3 ） Residual accommodation. Three groups have no relationship with age and refraction. （4） Romi eyedrop and, Mydrin-P eyedrop can be used in the cycloplegic refraction for children in myopia and hyperopia.