不同眼位招飞学生斜视度与近视屈光度比较研究

Comparative study on the degree of strabismus and myopia diopter of the pilot candidates with different eye positions

目的探讨间歇性外斜视(intermittent exotropia,IXT)、外隐斜视与眼位正常招飞体检学生的远近斜视度及等效球镜屈光度的差异。方法2016—2020年民航招飞体检眼科不合格学生13551名,分析其年度视力和屈光度、斜视不合格率趋势。从中选取2019—2020年参加招飞体检的338名高中生眼科检查资料,单纯IXT不伴垂直斜视者69例(IXT组)、眼位正常者114例(正位组)、外隐斜视者155例(外隐斜视组)。根据视近眼位控制能力将IXT组分为控制力强组(55例)和可控正位组(14例),外隐斜视组分为视近斜视度≤-6^(Δ)组(98例)和>-6^(Δ)组(57例)。分别比较控制力强组和可控正位组、视近斜视度≤-6^(Δ)组和>-6^(Δ)组、控制力强组和视近斜视度>-6^(Δ)组的近视率、等效球镜屈光度及视远斜视度。结果2016—2020年民航招飞体检眼科不合格学生中屈光度不合格率、斜视不合格率均有上升趋势。不同眼位组近视情况及视远斜视度比较差异均有统计学意义(χ^(2)/F=93.23、44.94、94.04、365.63,P值均<0.001)。外隐斜视组的等效球镜屈光度、视远斜视度均高于IXT组(P值均<0.05)。正位组近视率、视远斜视度低于IXT和外隐斜视组(P值均<0.05),等效球镜屈光度高于IXT和外隐斜视组(P值均<0.05),屈光度检出率差异均有统计学意义(P值均<0.05)。与可控制正位组相比,控制力强组的等效球镜屈光度更低,而视远斜视度更高,差异均有统计学意义(t=2.24、2.89,P=0.028、0.012)。与视近斜视度>-6^(Δ)组相比,视近斜视度≤-6^(Δ)组视远斜视度更高,差异有统计学意义(t=3.72,P<0.001);两组的近视率、等效球镜屈光度差异均无统计学意义。控制力强组的等效球镜屈光度、视远斜视度均较视近斜视度>-6^(Δ)组低,差异均有统计学意义(t=3.23、14.90,P=0.001、<0.001),而两组的近视率差异无统计学意义。结论民航招飞体检中IXT组学生的近视率、近视程度及视远斜视程度均为最高,外隐斜视组其次,正位组最低。

Objective To investigate the differences of close and distance strabismus degree and spherical equivalence of the students with intermittent exotropia(IXT),exophoria and orthophoria in physical examination of civil aviation recruitment.Methods The ophthalmic examination data of 13551 students,who failed in ophthalmology examination of civil aviation recruitment in Chengdu Civil Aviation Medical Center during 2016 to 2020,were collected and analyzed.The yearly trends of their visual,diopter and strabismus failure rates were analyzed.From 2019 to 2020,69 cases of IXT without vertical strabismus(IXT group),155 cases of exophoria(exophoria group)and 114 cases of orthophoria(orthophoria group)were found in ophthalmic examination.IXT group was further divided into well-controlled group(55 cases)and badly-controlled group(14 cases)by the eye position controlling ability.Exophoria group was further divided into close strabismus≤-6^(Δ)group(98 cases)and>-6^(Δ)group(57 cases).The myopia rate,spherical equivalent,distance strabismus degree were compared respectively between the well-controlled group and badly-controlled group,close strabismus≤-6^(Δ)group and>-6^(Δ)group,and well-controlled group and close strabismus>-6^(Δ)group.Results From 2016 to 2020,the failure rates of diopter and strabismus among the unqualified students in ophthalmology examination of civil aviation recruitment showed an increasing trend.There were significant differences on the degrees of myopia and distance strabismus among different eye position groups(χ^(2)/F=93.23,44.94,94.04,365.63,all P<0.001).The spherical equivalence and distance strabismus degree in exophoria group were higher than those in IXT group(both P<0.05).The myopia rate and distance strabismus degree in orthophoria group were lower than those in IXT and exophoria groups(all P<0.05),and the spherical equivalence was higher than that in IXT and exophoria groups(both P<0.05).There were significant differences in diopter detection rates(all P<0.05).Compared with the badly-controlled group,the spherical equivalence of the well-controlled group was lower and the distance strabismus degree was higher,and the differences were statistically significant(t=2.24,2.89,both P<0.05).Compared with the close strabismus>-6^(Δ)group,the close strabismus≤-6^(Δ)group had higher distance strabismus degree,and the difference was statistically significant(t=3.72,P<0.001).There was no significant difference in myopia rate and spherical equivalence between the 2 groups.The spherical equivalence and the distance strabismus degree of the well-controlled group were lower than those of the close strabismus>-6^(Δ)group,and the differences were statistically significant(t=3.23,14.90,P=0.001,<0.001),while there was no significant difference in myopia rate between the 2 groups.Conclusions The myopia rate and the degree of myopia and distance strabismus in IXT group are the highest,followed by esotropia and orthotropic group.