阿托品眼膏及环戊通眼液散瞳儿童验光结果对比分析

Comparison ofcyclopentolate versus atropine cycloplegia in Chinese children

目的 比较屈光不正儿童使用1%环戊通眼液与1%阿托品眼膏后检影验光结果的差异情况.方法 对226例（452只眼）屈光不正儿童使用环戊通眼液扩瞳后检影验光,48h后用1%阿托品眼膏对相同的患者再行扩瞳检影验光,比较两次验光结果.结果 远视组中两种药扩瞳验光结果球镜差值≤0.5D的眼数占72.2%,球镜差值＞0.5D的眼数为27.8%;阿托品眼膏扩瞳后验光的远视球镜值均高于环戊通眼液扩瞳后验光的结果.随着年龄增加,两种药验光的远视球镜差异值下降,2～5岁组与5～7岁组和7～12岁组比较,球镜差异值均有统计学意义.2～8岁组中近视球镜差值＞0.5D的眼数占9%,8～12岁组中近视球镜差值＞0.5D的占2.7%.混合性散光组中两种药扩瞳验光结果球镜差值＞0.5D的眼数占32%.使用两种药扩瞳后验光,近视和混合性散光组的前、后柱镜差值无统计学意义,而远视组的前、后柱镜差异有统计学意义,但差异＞0.5D的仅为1.8%.结论 1%环戊通眼液扩瞳验光结果与阿托品眼膏扩瞳验光结果比较,主要表现为球镜值的误差,柱镜值误差极小.8岁以上近视儿童首诊验光可使用环戊通作为睫状肌麻痹剂.12岁以下的远视和混合性散光儿童验光应尽量使用1%阿托品眼膏扩瞳.

Objective To compare the cycloplegic effects of 1% cyclopentolate and 1% atropine in Chinese children. Methods Examined refraction of 452 eyes in 256 Chinese children. 1% Cyclopentolate was instilled 3 times after 5-min intervals and refraction was evaluated 40 min after the last instillation. After 48 hours, 1% atropine was instilled third time daily for 3 days. Refractions were measured by the same optometrist.Results The power of astigmatism was not affected by either agent. Among the hyperopic eyes, 27.8% had more than 0.5DS difference after instillation of the two agents. More hyperopic sphere in atropine than cyclopentolate, and the difference was significant. Just 1.8% had more than 0.5 DS difference in the older than 8-year age of myopic children. There was 32% more than 0.5 DS difference in mixed astigmatism. Conclusions Though cyclopentolate is not as effective as atropine in all Chinese children. Nevertheless, 1% cyclopentolate can be a good agent for routine refractive status checking on myopic Chinese children over the age of 8 years.