1%阿托品眼用凝胶治疗早期近视青少年后双眼调节功能变化

Changes of adolescent binocular regulatory function after 1%atropine eye gel in treating early myopia

目的观察1%阿托品眼用凝胶治疗早期近视青少年后双眼调节功能变化情况。方法选取在该院就诊的屈光度数在-0.50~-2.00 D的青少年77例共149只眼,滴用1%阿托品眼用凝胶每晚1次,连续使用6个月后停药,共观察1年。根据用药前的调节反应将研究对象分为调节正常组、调节滞后组及调节超前组,用药后2周(基线)、3个月、6个月、9个月、12个月测量各组的屈光度及眼轴长度,用药前、用药后9个月、12个月测量各组的调节反应、调节幅度及调节灵敏度。结果用药后12个月,调节滞后组等效球镜度较基线增加,差异有统计学意义(t=6.797,P<0.001);而调节正常组和调节超前组等效球镜度与基线比较差异均无统计学意义(t=-1.874,P=0.065;t=0.119,P=0.905)。3组间各时间点眼轴长度比较差异无统计学意义(P>0.05)。用药前,调节滞后组和调节超前组的调节灵敏度均低于调节正常组,差异有统计学意义(P<0.05);用药后12个月,调节正常组和调节超前组的调节灵敏度较用药前增加,差异有统计学意义(t=-2.237,P=0.037;t=-8.838,P<0.001),同时调节超前组的调节反应趋于正常。结论调节正常和调节超前的近视儿童使用1%阿托品眼用凝胶比调节滞后者更能有效改善调节功能,控制近视度数增长。

Objective To observe the changes of adolescent binocular accommodative function after 1%atropine ophthalmic gel in treating early myopia.Methods A total of 149 eyes in 77 adolescents with the diopter ranging-0.50--2.00 D treated in this hospital were included.1%atropine eye gel was dripped once every night for 6 months,stopped after consecutive six months,and observed for 1 year.According to the accommodative response before medication,the study subjects were divided into the accommodative normal group,accommodative lag group and accommodative advance group.The diopter and the axial length of the eyes were measured in 2 weeks(baseline),3,6,9,12 months after the treatment.The accommodative response,accommodative amplitude and accommodative sensitivity of each group were measured before treatment,in 9,12 months after treatment.Results In 12 months after treatment,the spherical equivalent in the accommodative lag group was increased compared with the base line,and the difference was statistically significant(t=6.797,P<0.001);but the spherical equivalent in the accommodative normal group and accommodative advance group had no statistical difference compared with the base line(t=-1.874,P=0.065;t=0.119,P=0.905).There was no statistical significant difference in the length of the eye axis at each time point among the three groups.Before medication,the adjustment sensitivity in the accommodative normal group and accommodative advance group were lower than that in the accommodative normal group,and the difference was statistically significant(P<0.05);after 12-month medication,the adjustment sensitivity in the accommodative normal group and accommodative advance group were increased compared with that before medication,and the difference was statistically significant(t=-2.237,P=0.037;t=-8.838,P<0.001),meanwhile the accommodative reaction in the accommodative advance group trended to normal.Conclusion Using 1%atropine eye gel in the myopia children with accommodative normal and advance can more effectively improve the accommodative function than the children with accommodative lag and control the increase of glasses power.