青少年眼调节与非调节状态下眼前节结构生物测量对比分析

目的 探讨小学生和中学生在调节和非调节状态下眼前节部分解剖结构的动态变化规律。方法 横断面研究。采用超生生物显微镜（UBM）检测福州市54例小学生及55例中学生在调节和非调节状态下的睫状体、虹膜及房角等位置相关数据，数据采用配对t检验和独立样本t检验进行分析。结果 非调节状态下小学生组各指标数值如下：睫状突长度（CPD）值（160.53±17.78）μm，睫状突宽度（CT）值（90.01±34.30）μm，虹膜睫状体距离（ICPD）值（23.11±3.33）μm，虹膜厚度（IT）1值（35.95±6.60）μm，IT2值（52.81±9.94）μm，小梁睫状体距离（TCPD）值（151.27±23.11）μm，巩膜外侧面与虹膜长轴的夹角θ3值（39.23±7.46）°，虹膜外侧面与睫状突的夹角θ4值（56.02±6.75）°；调节状态下相应指标分别为：（187.62±15.44）μm、（74.23±19.87）μm、（19.78±2.69）μm、（30.34±5.83）μm、（47.11±6.71）μm、（131.55±20.02）μm、（31.68±5.14）°、（50.39±4.89）°。调节与非调节状态下比较，差异均有统计学意义（t=8.45、2.93、5.72、4.68、3.49、4.74、6.12、4.96，P＜0.05）。中学生组非调节状态下以上各指标分别为：（214.64±15.25）μm、（99.13±17.80）μm、（27.92±9.00）μm、（40.72±6.43）μm、（56.57±9.13）μm、（176.82±28.06）μm、（43.73±6.93）°、（60.15±10.48）°；调节状态下分别为：（271.38±11.96）μm、（93.27±10.42）μm、（21.66±7.54）μm、（35.68±4.37）μm、（50.17±6.49）μm、（136.41±19.35）μm、（39.51±5.28）°、（53.68±9.12）°。调节与非调节状态下各参数比较，差异均有统计学意义（t=20.91、2.03、3.81、4.63、4.08、8.47、3.46、3.33，P＜0.05）。同样在调节状态下，小学生组和中学生组所有睫状体相关指标之间差异都存在统计学意义（t=30.95、6.10、4.47、5.29、2.37、7.70、2.32、6.98，P＜0.05）。结论 人眼进行视近调节时，睫状体的变化最为显著，出现各部肌纤维尤其是环形肌协调收缩，并向前向内移动，使晶状体悬韧带松弛，实现眼屈光力的增加；且年龄越小，调节力越强。

Comparative analysis of biological measurements of anterior segment structures with and without accommodation in human eyes

ObjectiveTo investigate the dynamic changes in the anatomy of the anterior segment with and without accommodation in primary and middle-school students. MethodsThis was a cross-sectional study. Ultrasound biomocroscopy （UBM） was used to test 54 primary students and 55 middle-school students in Fuzhou. Some parameters related to the ciliary body， iris， anterior chamber angle and other relevant data were measured with UBM. Data were analyzed using a paired t test and independent-samples t test. ResultsResults for the primary student group without accommodation were as follows： the ciliary process distance （CPD） was 160.53±17.78 μm， ciliary body thickness （CT） was 90.01±34.30 μm， iris-ciliary process distance （ICPD） was 23.11±3.33 μm， iris thickness （IT） 1 was 35.95±6.60 μm and IT2 was 52.81±9.94 μm， trabecular ciliary process distance （TCPD） was 151.27±23.11 μm， θ3 was 39.23°±7.46°， and θ4 was 56.02°±6.75°. The results with accommodation were as follows： 187.62±15.44 μm， 74.23±19.87 μm， 19.78±2.69 μm， 30.34±5.83 μm， 47.11±6.71 μm， 131.55±20.02 μm， 31.68°±5.14°， and 50.39°±4.89° （t=8.45， 2.93， 5.72， 4.68， 3.49， 4.74， 6.12， 4.96， P＜0.05）. The respective results for the middle-school student group without accommodation were as follows： 214.64±15.25 μm， 99.13±17.80 μm， 27.92±9.00 μm， 40.72±6.43 μm， 56.57±9.13 μm， 176.82±28.06 μm， 43.73°±6.93°， and 60.15°±10.48°. Results with accommodation were as follows： 271.38±11.96 μm， 93.27±10.42 μm， 21.66±7.54 μm， 35.68±4.37 μm， 50.17±6.49 μm， 136.41±19.35 μm， 39.51°±5.28°， and 53.68°±9.12° （t=20.91， 2.03， 3.81， 4.63， 4.08， 8.47， 3.46， 3.33， P＜0.05）. There was a significant difference between these 2 groups with accommodation（in the same sequence， t=30.95， 6.10， 4.47， 5.29， 2.37， 7.70， 2.32， and 6.98， P＜0.05）. ConclusionThe most significant change occurs in the ciliary body with near accommodation： muscle fibers contract， especially in the circular muscles， and move forward and inward to induce the suspensory ligaments of the lens to loosen， thus achieving intense accommodation. The response is correlated with age： the younger the child， the more intense the response.