消旋山莨菪碱对人眼调节和瞳孔的影响

Effect of 0.5% raceanisodamine on accommodation and pupil size in human eyes

目的观察0.5%消旋山莨菪碱对人眼调节及瞳孔大小的影响。方法将44例7～17岁屈光不正患者分为复方托吡卡胺组及消旋山莨菪碱组,采用开放视野自动验光仪测量右眼注视不同距离(6.0、0.5、0.25、0.17m)视标干预前后的调节刺激反应。采用眼前节相干光断层扫描仪测量消旋山莨菪碱组在0、-2、-4、-6D调节状态下干预前后右眼眼前节生物学指标的变化。结果复方托吡卡胺组干预前后调节刺激反应曲线斜率变化有统计学意义(t=15.281,P=0.000),消旋山莨菪碱组差异无统计学意义(t=1.865,P=0.692)。消旋山莨菪碱组干预前后前房深度均呈递减变化(F值分别为20.17及28.10,P<0.05);晶状体厚度均呈递增变化(F=35.86及26.70,P<0.05);干预前随调节增强瞳孔大小呈递减变化(F=5.60,P<0.05),干预后瞳孔未随调节变化发生改变(F=1.22,P=0.321)。结论 0.5%消旋山莨菪碱有扩瞳作用,调节麻痹作用极弱。

Objective To investigate the effect of 0.5% raceanisodamine on accommodation and pupil size in human eyes. Methods Forty-four subjects aged from 7 to 17 years were divided into raceanisodamine group and com- pound tropicamide group. Accommodation stimulus responses of the two groups were measured in the right eye with open- field autorefractor at 6.0, 0.5, 0. 25 and 0. 17 m distances respectively. Biometric changes of the anterior segment in raceanisodamine group were measured in the right eye at 0, -2, -4 and -6 D accommodated states respectively. Results There was a significant difference in slope of accommodation stimulus response curves between pre- and post-administra- tion of compound tropicarnide eye drop（ t = 15. 281 ,P = 0.000） , while no significant difference in slope was found be- tween pre- and post-administration of 0.5% raceanisodamine（t = 1. 865 ,P =0. 692）. Lens thickness increased gradually before and after administration of 0.5% raceanisodamine（ F = 20.17 ; P 〈 0.05 ; F = 28.10 ; P 〈 0.05 ）. Anterior cham- ber depth decreased progressively before and after administration of 0.5% raceanisodamine （ F = 35.86, P 〈 0.05 ; F = 26.70 ,P 〈 0.05 ）. Pupil diameter decreased with an increase in accommodation before administration of 0. 5% raeeaniso- damine （F = 5.60, P 〈 0. 05 ）, but it showed no change after administration （F = 1.22, P = 0. 321 ）. Condusions 0.5 % raceanisodamine could .dilate pupil and had little cycloplegic effect. （Chin J Ophthalmol and Otorhinolaryngo1,2010,10： 215-217）