远视儿童应用1%环戊通与1%阿托品检影验光的比较

Comparative study of cyclopentolate 1% and atropine 1% in retinoscopic refraction for Chinese hyperopic children

目的比较3～7岁远视儿童先后应用1％环戊通与1％阿托品散瞳检影验光的屈光度值。方法对我院眼科门诊3～7岁儿童，先用1％环戊通滴眼液点眼3次后检影验光；对一眼远视屈光度值≥＋0．75D者，再采用1％阿托品眼膏点眼3d后检影验光。共50例（90眼）纳入本研究，年龄（5．3±1．4）岁。屈光度按等效球镜值计算，应用配对t检验和Х^2检验对数据进行统计学处理。结果①应用1％环戊通和1％阿托品验光的屈光度值分别为（＋3．67±2．39）D和（＋4．52±2．49）D，P〈0．001；②伴有内斜视组应用1％环戊通和1％阿托品验光的屈光度值分别为（＋3．95±2．30）D和（＋4．91±2．51）D，P〈0．001，两者屈光度差值为（＋0．97±0．75）D；不伴内斜视组应用1％环戊通和1％阿托品验光的屈光度值分别为（＋3．32±2．49）D和（＋4．03±2．41）D，P〈0．001，两者屈光度差值为（＋0．70±0．40）D；③在应用两种药物验光的屈光度差值≤0．75D的55眼和〉0．75D的35眼中。应用1％环戊通初始验光的屈光度≥＋3D和〈＋3D眼数的差异无统计学意义（P=0．562）。结论对于3～7岁远视儿童尤其是伴有内斜视者，应首选使用1％阿托品散瞳验光。

Objective To compare cycloplegic retinoscopic refractions using cyclopentolate 1% and atropine 1% in Chinese hyperopic children of 3 to 7 year old. Methods Cyclopentolate 1% was used for cycloplegic retinoscopy on 3 to 7 years old children from the outpatient clinic, and 1 week later, atropine 1% was used for cycloplegic retinoscopy on children who had a cycloplegic refraction larger than ＋0.75D. 50 children （90 eyes） were enrolled in this study. Re- fraction was presented as spherical equivalent （ SE）, and paired sample t test and Х^2 test were used to analyze the data. Results （ 1 ） The SE of retinoscopy for cyclopentolate 1% and atropine 1% was ＋ 3.67 ± 2.39D and ＋ 4.52± 2.49 D, respectively （ P 〈 0.001 ） ; （2） in esotropic children, the SE of retinoscopy for cyclopentolate 1% and atropine 1% was ＋ 3.95 ±2.30D and ＋ 4.91 ± 2.51 D, respectively （ P 〈 0.001 ） ; in children without esotropia, the SE of retinoscopy for cyclopentolate 1% and atropine 1% was ＋3.32 ±2.49D and ＋4.03 ±2.41D, respectively（P 〈0.001） ; the SE difference between cyclopentolate 1% and atropine 1% in esotropic and non-esotropic children was ＋ 0.97 ± 0.75D and ＋0.70±0.40D, respectively（P 〈0. 001 ） ; （3）in 55 eyes with SE difference ≤0.75D and 35 eyes with SE difference 〉0.75D, the number of eyes with cyclopentolate 1% SE I〉 ＋3D and 〈 ＋3D had no statistical difference （P = 0.562）. Conclusion In 3 to 7 year old Chinese hyperopic children, especially esotropic children, atropine 1% is the choice of drug in cycloplegic retinoscopy.