先天性上睑下垂对眼散光量及轴长的影响

Effect of congenital ptosis on astigmatism and axis length

目的:评价先天性上睑下垂严重程度与眼总散光、角膜散光和眼内散光的关系及其对眼轴长的影响,并探究与弱视发生之间的关系。方法:先天性上睑下垂患者50例100眼,按正常、轻、中、重度下垂分列Ⅰ,Ⅱ,Ⅲ,Ⅳ组,Ⅰ:33眼;Ⅱ:20眼;Ⅲ:17眼;Ⅳ:30眼;首先进行规范的医学验光,以其散光绝对值为眼球总散光值;接着角膜地形图仪测量双眼角膜地形至少3次,取结果最好者记录角膜散光值;按公式:眼内散光=总散光-角膜散光,记录眼内散光。最后A超测量双眼轴长各5次,取其平均值。结果:总散光,角膜散光总体比较有显著差异(P=0.000,0.002<0.05),且与上睑下垂严重呈一定正相关(Spearman r s=0.514,0.721,P均<0.05);但角膜散光轴向、眼轴长度、眼内散光总体比较统计学无显著性差异(P均>0.05),其中散光轴向、眼内散光与上睑下垂严重程度亦无明显相关性。结论:先天性上睑下垂对眼散光的影响主要是通过角膜散光发生,其散光的严重程度与上睑下垂严重程度相关,但是对眼轴长不产生明显影响。弱视在重度上睑下垂眼更加常见,高的角膜散光与其有关,且多为中度的顺规散光。

AIM： To investigate the effects of congenital ptosis degree on total astigmatism, corneal astigmatism, intraocular astigmatism and axis length, and to discuss the relation with amblyopia. METHODS： Fifty patients （100 eyes） with congenital ptosis were selected and divided into four groups： 33 eyes ingroup I （normal）; 20 eyes in group II （mild）; 17 eyes in group III （moderate）; 30 eyes in group IV （severity）. Firstly, they received standardized medical optometry. Absolute value of astigmatism was recorded as total astigmatism. Then, corneal topography was used to measure double eyes for at least 3 times, and the best results were used to record the SimK. Define absolute value of /kSimK as corneal astigmatism. Finally, axial length was measured for 5 times by A super measurement, and take the mean value. Formula： intraocular astigmatism ：total astigmatism - corneal astigmatism. RESULTS： There was a significance difference between total astigmatism and cornea astigmatism （P = 0. 000, 0. 002〈 0. 05）. Also they were positive correlation with severity of ptosis （ Spearman rs = 0. 514, 0. 721, P〈0.05 ）, but there was not significance difference in axial orientation, intraocular astigmatism and axial length （all P〉 0.05）. The axial orientation, intraocular astigmatismhad no correlation with severity of ptosis. CONCLUSION. The congenital ptosis affects on eye astigmatism through the change of cornea astigmatism, which is related to severity of ptosis, but has no effect on axial length. The rate of amblyopia is higher than normal on congenital ptosisespecially severity. Amblyopia is related to high astigmatism which is moderate astigmatism with rule.