常用隐斜视测量方法有效性的比较

Comparison of validity of several common phoria tests

目的比较4种常用的隐斜视测量方法的有效性。方法选取西安医学院大学生中存在聚散功能障碍者32人,分别使用Von Graefe法、加遮盖Von Graefe法、Maddox rod法及加遮盖Maddox rod法对各受试者分别进行远距(眼前5m)及近距(眼前40cm)隐斜视的检查。利用Sheard准则或1∶1准则分别计算出由不同隐斜视测量方法所得的氉试验性棱镜处方,调整棱镜度以交替遮盖后眼位运动快速、平滑作为实际棱镜处方的判定标准。统计分析各种方法所得试验性棱镜处方与实际棱镜处方之间的差异,评价各种隐斜视测量方法的有效性。结果远距隐斜视测量值Von Graefe法(-14.594△±2.513△)较Maddox rod法(-13.562△±2.449△)更偏外隐斜(P=0.000),近距隐斜视测量值Maddox rod法(-14.906△±6.198△)较Von Graefe法(-14.469△±6.461△)更偏外隐斜(P=0.011)。Von Graefe法、加遮盖Von Graefe法、Maddox rod法及加遮盖Maddox rod法试验性棱镜处方分别为3.984△±1.417△、4.516△±1.459△、3.500△±1.391△、4.297△±1.453△,其中Von Graefe法所得试验性棱镜处方与实际棱镜处方(3.936△±1.441△)的相关性最高(r=0.979,P=0.000),且二者间的差异不具有统计学意义(P=0.374);其余3种方法与实际棱镜处方的相关程度由高到低依次为加遮盖Von Graefe法(r=0.952,P=0.000)、加遮盖Maddox rod法(r=0.945,P=0.000)及Maddox rod法(r=0.937,P=0.000)。结论不配合遮盖的Von Graefe法与实际棱镜处方的相关性最强,其有效性最好。

Objective To compare the validity of several common phoria tests. Methods Thirty-two college student volunteers with convergence dysfunction were selected and measured by four different phoria tests：Von Graefe test, Flash Von Graefe test,Maddox rod test and Flash Maddox rod test at distance （5 m） and near （40 cm）. The experimental prism prescription were calculated with Sheard principle or 1 ： 1 principle using four different phoria measurement values, and the final prism prescription were determined by alternative cover test. The correlation of the four experimental prism with the final prism prescription were analyzed. Results The Von Graefe test value （ - 14. 594△ ±2. 513△ ） was significantly more exophoric than the Maddox rod test findings at distance （ -13. 562△± 2.449△） （P = 0. 000） ,but the Maddox rod test findings at near （ - 14. 905△ ± 5. 198△ ） was significantly more exophoric than the Von Graefe test value （ - 14.459 △ ± 6.451 △ ） （p = 0.011 ）. The experimental prism prescription of Von Graefe test, flashed Von Graefe test, Maddox rod test, flashed Maddox rod test were 3.984 △ ± 1. 417 △ , 4. 516 △ ± 1. 459△ , 3. 500 △ ± 1. 391 △ , 4. 297 △ ± 1. 453△ , respectively,in which the intensity of correlation of the experimental prism using Von Graefe test with the fmal prism prescription （3. 936△ ± 1. 441△ ） was the strongest（r = 0.979 ,P = 0.000 and had no statistical significance （P = 0. 374）, then followed by flash Von Graefe test （ r = 0. 952, P = 0. 000 ）, flashed Maddox rod test （ r = 0. 945, P = 0. 000 ） and Maddox rod test （ r = 0. 937, P = 0. 000）. Conclusion Von Graefe test has the strongest correlation with the final prism prescription, so it has the best validity.