婴幼儿148只眼角膜曲率分析

Corneal curvature analysis in 148 infant eyes

目的探讨婴幼儿角膜曲率特点及手持式角膜曲率计的可行性。方法横断面研究。使用手持式角膜曲率计测量对2014年9月至2015年6月间在上海新华医院眼科特检室就诊的3岁以下婴幼儿角膜曲率。对除外视网膜脱离及眼前节发育异常的95例148只眼角膜曲率进行分析。结果平均角膜曲率及角膜散光分别为（44.07±2.02）D和（2.25±1.41）D，顺规性散光占74%（110/148）。正常眼与其它非视网膜脱离的先天性眼病患眼比较，其平均角膜曲率、角膜散光的差异均无统计学意义（P值分别为0.474和0.165）。其中早产儿视网膜病变眼均值最大。分年龄段组间对比显示：小于3个月的婴儿眼，其平均角膜曲率（46.07±2.24）D、角膜散光（3.20±1.71）D与其它年龄组的差异有统计学意义（P值分别为0.007和0.014）。其它年龄组均值分别为（43.85±1.87）D和（2.14±1.33）D，组间差异无统计学意义（P〉0.05）。男女性别、左右眼别组间对比，同一个体左右眼配对比较，其平均角膜曲率、角膜散光差异无统计学意义（P〉0.05）。结论3岁以下婴幼儿角膜曲率变异度大。尤其小于3个月的婴儿眼角膜曲率大，散光度大。手持式角膜曲率计是准确测量婴幼儿角膜曲率的有用工具。

Objective To investigate the characteristics of infant corneal curvature and the feasi- bility of handheld keratometer for infant comeal measurement. Methods A cross-sectional study. The corneal curvature was measured by a handheld keratometer in infants under 3 years old who visited the ophthalmology auxiliary examination department of Shanghai Xinhua Hospital during September 2014 to June 2015. Excluding retinal detachment and anterior segment abnormalities, data of 148 eyes of 95 children were analyzed. Results The average keratometry and corneal astigmatism were 44.07±2.02D and 2.25±1.41D, 74% （110/148） of which showed with-the-rule astigmatism. The average keratometry and corneal astigmatism in normal eyes and congenital disease eyes without retinal detachment showed no significant difference between groups （P =0.474, P =0.165）, wherein the data of ROP group were the greatest. The average ketatometry （46.07±2.24D） and corneal astigmatism （3.20±1.71D） in group under 3 months were significantly higher compared to other age groups （P = 0.007, P =0.014）, while there showed no statistical difference within other age groups with the average keratometry of 43.85±1.87D and comeal astigmatism of 2.14±1.33D （P 〉0.05）. Neither statistical difference was found between female and male, right eyes and left eyes, or paired t-test between two eyes of the same individual （P 〉0.05）. Conclusions The variation of corneal curvature in children under 3 years old is large, In infants less than 3 months, the ketatometry and corneal astigmatism are especially higher. Hand held keratometer could be a useful tool for accurate measurement of corneal curvature in infants.