老视客观检查法的探索和应用

Comparative study of three method in measurement of presbyopia

目的 探索一种可用于临床客观检查、简便可行的老视检查装置,并评价此种装置在老视测定中的应用价值.方法 自制分光同时视验光镜架,对60例45～65岁的老视患者进行老视检查,每位患者皆分别采用经验法、规范验光方法[移近法测调节幅度、试验性近附加=工作距离（用屈光度表示）-1/2调节幅度、正负相对调节进行精细调整]、分光同时视检影法进行检查,记录每种方法测量所需时间及配镜度数,就3种测量方法所测得的结果与最终处方的符合程度、验配的速度作比较分析.结果 45～54岁患者检查结果：（1）经验法、规范验光方法及分光同时视检影法所得的配镜度数无明显差异（P ＞0.05）;规范验光方法与分光检影法一致性较好,临床上可接受.（2）分光同时视检影法所消耗的时间介于规范验光方法和经验法之间,差异有统计学意义（P＜0.05）.55～65岁患者检查结果：（1）经验法、规范验光方法及分光同时视检影法所得的配镜度数两两比较差异均有统计学意义（均P＜0.01）;分光检影法一致性较其余两者好,临床上可接受.（2）分光同时视检影法所消耗的时间介于规范验光方法和经验法之间,差异有统计学意义（P＜0.01）.结论 分光同时视检影法是一种可靠而又简便可行的老视患者ADD客观检查装置;对于45～65岁年龄段患者,相对于经验法和规范验光方法,分光同时视检影法更具优越性.

Objective To evaluate the reliability and practicability of a modified apparatus of synoptophore with semireflective in measuring ADD of presbyopia. Methods A modified synoptophore containing a refractive frame with semireflective mirror was tested in 60 patient aged 45 to 65. Patients were inspected by three methods： empirical method, clinical convention method（ measured AMP by move nearer, ADD = 1/d - 1/2AMP,NRA/PRA to adjustment ）and retinoscopy through the modified apparatus of synoptophore with semireflective mirror. The prescriptions and measuring time for each method were recorded and compared. Results In age group 45-54,there were no significant differences in prescriptions among empirical method, clinical convention method and the measurement with the modified apparatus of synoptophore with semireflective mirror （P 〉0.05）. The measuring time of the modified apparatus was shorter than that of clinical conventional method. （P〈0.05）. In age group 55-65 there were significant differences in prescription glasses among three methods （P〈0.01）. The measuring time of the modified apparatus was shorter than that of clinical conventional method, Conclusion The measurement with the modified apparatus of synoptophore with semi-reflective-mirror is a reliability and practicability objective measurement for ADD of presbyopia.