阿托品凝胶、盐酸环喷托酯和复方托吡卡胺睫状肌麻痹效果比较

Evaluation of cycloplegic effectiveness of atropine,cyclopentolate and tropicamide

目的:比较阿托品凝胶、盐酸环喷托酯和复方托吡卡胺在近视中小学生睫状肌麻痹验光中的效果,为科学验光和准确矫正提供理论依据。方法:选取2017-07/08在我院经小瞳验光诊断为近视的中小学生420例818眼,按年龄分为3组,分别采用阿托品凝胶、盐酸环喷托酯和复方托吡卡胺进行睫状肌麻痹验光(散瞳验光)及小瞳复光。结果:阿托品组、盐酸环喷托酯组、复方托吡卡胺组睫状肌麻痹验光与小瞳复光等效球镜符合率分别是:81.0%、81.3%和79.4%;睫状肌麻痹验光与小瞳复光等效球镜之差阿托品组为-0.113±0.226D,差异有统计学意义(t=-4.663,P<0.001);盐酸环喷托酯组为-0.025±0.192D,复方托吡卡胺组为-0.026±0.193D,差异均无统计学意义(t=-1.665,P=0.099;t=1.760,P=0.080)。结论:对>8岁的近视中小学生,首次睫状肌麻痹验光可采用快速散瞳,以减少对学习生活的影响;快速散瞳者复光配镜时可按小瞳结果直接给予处方,阿托品散瞳者小瞳复光近视屈光度高于散瞳时,配镜时需参考散瞳结果,选择最佳矫正视力的最低负镜度,避免近视过矫。

·AIM:To investigate the effectiveness of three cycloplegia drugs:atropine,cyclopentolate and tropicamide on school-age children,and provid theoretical basis in choosing cycloplegic drugs for school-age children.·METHODS:Totally 420 myopic school-age students(818 eyes)in out-patients department were selected during July to August 2017.Candidates were divided into three medicine groups according to their age:Group A:<8 years old,utilizing 1%atropine;Group B:8-12 years old,utilizing the cyclopentolate;Group C:>12 years old,utilizing the tropicamide.The difference of refraction degree before and after medicine application were calculated.·RESULTS:The coincidence rate of spherical equivalent refraction with cycloplegia and without cycloplegia was 81.0%in atropine group,81.3%in cyclopentolate group and 79.4%in tropicamide group respectively.There was statistical difference of refraction results of the Group A between with atropine cycloplegia and without cycloplegia.The mean difference was-0.113±0.226D(t=-4.663,P<0.001).There was no statistical refraction difference of the Group B between with cyclopentolate cycloplegia and without cycloplegia,the mean difference was-0.025±0.192D(t=-1.665,P=0.099).So does the difference of Group C between with tropicamide cycloplegia and without cycloplegia,which was-0.026±0.193D(t=1.760,P=0.080).·CONCLUSION:For children older than 8-years old and without strabismus and amblyopia,cyclopentolate or tropicamide can be used to give cycloplegia refraction for the first time,which is convenient for their daily activities.The cycloplegia refraction results should been re-checked after used atropine,and giving prescription by using the principle of maximum plus to maximum visual acuity(MPMVA).