睫状肌麻痹前后开放式验光仪与主觉验光测量结果的比较

Comparison of open-field autorefraction and subjective refraction with and without cycloplegia

目的比较双眼开放视野自动验光仪(WAM-5500验光仪)在睫状肌麻痹前后测量人眼屈光状态的结果与睫状肌麻痹后主觉验光结果的差异。方法序贯收集89例(177只眼)江苏省中医院就诊的屈光不正患者,分别在睫状肌麻痹前后对患者进行WAM验光仪的客观验光以及睫状肌麻痹后的主觉验光。计算球镜度数(SD)、等效球镜(SE)与散光轴的符合率并进一步比较分析两者SD、SE、JO、J45散瞳前后数据的一致性和差异。结果睫状肌麻痹前,WAM验光仪SD、SE、柱镜度数与散光轴与睫状肌麻痹后主觉验光相比,符合率分别为75.1%、73.4%、81.4%、90.4%。睫状肌麻痹后,WAM验光仪SD、SE、柱镜度数与散光轴与睫状肌麻痹后主觉验光相比,符合率分别为85.9%、87.0%、81.4%、94.4%。睫状肌麻痹前,WAM验光仪所测得SD均较睫状肌麻痹后主觉验光结果偏负0.31 D,差异有统计学意义(P<0.001),SE也有相应趋势(P<0.001),而J0和J45结果差异无统计学意义(P=0.834;P=0.207)。睫状肌麻痹后,WAM验光仪所测得SD,SE,J0和J45结果与主觉验光相应结果相比均无统计学差异(P=0.197;P=0.595;P=0.391;P=0.291)。结论在临床应用中,无论在睫状肌麻痹前还是睫状肌麻痹后,WAM-5500验光仪的测量结果表现出良好的准确性和可靠性,但尚不能去除调节力对于验光结果的影响,不能完全替代睫状肌麻痹验光。

Objective To evaluate the accuracy of binocular open field autorefractor(WAM-5500 autorefractor),and compare it with the subjective refraction with and without cycloplegia in diagnosing refractive error in school-age children.Methods A prospective case-control study.89 patients(177 eyes)who were diagnosed with refractive error at the Jiangsu Hospital of Traditional Chinese Medicine from July to September 2020 were collected in sequence.The patients underwent WAM autorefractor examination with and without cycloplegia as well as subjective refraction with cycloplegia.The coincidence rate of sphere diopter(SD),sphere equivalent(SE),cylinder power and axis were calculated.Further analysis was performed to compare the difference of SD,SE,Jackson cross cylinder at 0°and 45°(J0 and J45)with and without cycloplegia.Results Without cycloplegia the coincidence rates of SD,SE,cylinder power and axis of WAM were 75.1%,73.4%,81.4%and 90.4%,respectively.With cycloplegia the coincidence rates of SD,SE,cylinder power and axis of WAM were 85.9%,87.0%,81.4%and 94.4%respectively.The mean SD measured by WAM was 0.31D more negative than those after cycloplegia(P<0.001).The SE also had a similar trend(P<0.001).J0 and J45 showed no statistical difference(P=0.834;P=0.207).With cycloplegia the mean SD and SE measured by WAM had no significant difference compared with the results of subjective refraction(P=0.197;P=0.595;P=0.391;P=0.291).Conclusions Clinically WAM has good correlation and consistency with the subjective refraction results regardless of the application of cycloplegia.However,WAM can not remove the influence of accommodation completely,and it can not completely replace cycloplegic refraction.