盐酸环喷托酯在空军青少年航空学校招飞选拔验光中应用的可行性分析

Comparison of cyclopentolate and tropicamide for cycloplegic refractions in teenagers with low ametropia

目的探讨盐酸环喷托酯(cyclopentolate,CY)在招飞低度近视学生验光中的应用。方法随机抽取2015级青少年航空学校学生61名(122眼),均为男性,年龄17~19(17.54±1.65)岁。所有抽选的学生单眼最佳矫正视力≥1.0。分别应用盐酸环喷托酯和托比卡胺(tropicamide,TR)扩瞳后,检影验光法检测学生的屈光度值,比较两种药物扩瞳后的屈光度差异,并分析两种药物验光屈光度的相关性。结果青少年学生应用盐酸环喷托酯睫状肌麻痹后验光的等效球镜(spherical equivalent,SE)及球镜屈光度显著高于托比卡胺药物验光屈光度(P <0.05),平均相差0.125 D;二者验光柱镜屈光度无统计学差异(P=0.346)。两种药物验光SE、球镜及柱镜屈光度呈强相关性(r=0.894,P=0.000;r=0.896,P=0.000;r=0.709,P=0.000)。按TR验光的屈光度分组,近视及远视组CY验光的SE屈光度均显著高于TR(P <0.05)。依据医学选拔标准,TR验光近视超标但CY验光合格者共18眼,99%CI区间为-0.834^-0.622 D。结论盐酸环喷托酯与托比卡胺对低度屈光不正青少年学生睫状肌麻痹效果差异较小,且一致性较好;盐酸环喷托酯对招飞定选边缘性屈光学生有一定的应用价值。

Objective To investigate the application of cyclopentolate in candidates of flying cadets with low myopia. Methods A total of 61 male participants（122 eyes） aged 17-19（17.54±1.65） years old were randomly selected from Grade 3（2015） students in teenager aviation schools. The best corrected visual acuities of all the participants were greater than or equal to 1.0. Compound tropicamide（TR） eye drop and 1% cyclopentolate（CY） eye drop were used for mydriasis in the same individual on two separate days, and the spherical equivalent（SE） related to these two drugs were calculated and compared. The difference and correlation of SEs using TR and CY were tested by Wilcoxon rank-sum test and Spearman correlation test separately. Results The SE and spherical power using CY was significantly higher than that of TR（P〈0.05）, and the difference was-0.125 D. The correlation of SEs, spherical power and cylindrical power using CY and TR were of statistically significant difference（r=0.894, P=0.000; r=0.896, P=0.000; r=0.709, P=0.000, respectively）. Grouping by results of TR, the myopia group and hyperopia group had higher SEs using CY than TR（P〈0.05）. According to the standard of medical selection, there were 18 eyes exceeding the myopia standard using TR（99% CI,-0.834--0.622 D）, but they were qualified using CY. Conclusion The cycloplegic effect of cyclopentolate is stronger than that of tropicamide, with little difference and good consistency, which has certain application value in the selection of candidates of flying cadets with borderline refraction.