间歇性外斜视患者的眼球旋转情况研究

目的 研究间歇性外斜视患者眼球旋转情况。设计回顾性病例系列。研究对象2021年10月至2022年7月北京同仁医院5～16岁间歇性外斜视患者108例及正常对照108例。方法免散瞳眼底照相检查,使用Image J软件测量视盘-黄斑中心凹夹角(DFA),外旋为黄斑中心位于视盘下缘水平线以下,内旋为黄斑中心居于视盘中心水平线以上,位于两者之间则认为无旋转。分析间歇性外斜视组患者眼球旋转与修正纽卡斯尔控制力评分、斜视角度、立体视的相关性。主要指标DFA、眼球旋转情况及与修正纽卡斯尔控制力评分、斜视角度、立体视的相关性。结果间歇性外斜视组患者平均DFA为(6.17±3.18)°,明显大于正常对照组的(5.36±2.50)°(t=2.939,P=0.003)。间歇性外斜视组患者眼球旋转(内旋及外旋)者33眼(15.28%),明显高于对照组的14眼(6.48%)(χ²=8.843,P=0.003)。间歇性外斜视患者的DFA大小与修正纽卡斯尔控制力评分及斜视角度、远近立体视均具有显著正相关性(r=0.634,P<0.001;r=0.353,P<0.001;r=0.370...     

屈光参差性弱视儿童视网膜光学相干断层成像研究

目的：应用视网膜光学相干断层成像方法（OCT）研究屈光参差性弱视儿童视网膜神经纤维层（RNFL）和黄斑中心凹厚度,探讨弱视的发病机制。方法对屈光参差性单眼弱视儿童38例进行OCT检查,据弱视眼屈光状态分为远视散光弱视组18例,单纯远视弱视组20例,对侧健眼为正常对照组。分析比较三组视盘周围RNFL厚度和黄斑中心凹厚度的差异。结果远视散光弱视组、单纯远视弱视组和正常对照组视盘周围RNFL厚度分别为115.77±13.42μm、111.34±10.30μm 和103.05±11.10μm,黄斑中心凹厚度分别为198.86±28.30μm、191.98±27.81μm,181.18±29.06μm。两弱视组分别与正常对照组、两弱视组组间比较视盘周围RNFL厚度及黄斑中心凹厚度,差异均有统计学意义,P＜0.05。结论屈光参差性弱视其弱视眼视盘周围RNFL厚度及黄斑中心凹厚度较对侧正常眼增厚,且远视散光弱视眼厚于单纯远视弱视眼。     

后天性外旋转斜视手术前后的立体视觉观察

目的探讨后天性外旋转斜视患者行上斜肌矢状移位术前、后的立体视觉。方法对14例主述下方注视野旋转复视明显、行上斜肌矢状移位术的后天性外旋转斜视患者资料进行回顾性总结和分析,比较手术前、后患者的眼位、眼球运动、旋转斜视度数及双眼立体视觉情况。结果全部患者术前均主诉下方注视野旋转复视症状明显,术后视物效果自然、清晰。双马氏杆法检查术前上方注视野外旋≤10°,正前方注视野外旋10°～20°,下方注视野外旋15°～20°;术后上方注视野外旋消失、减弱或产生少许内旋(外旋4°～内旋3°),正前方注视野外旋减弱(外旋≤8°),下方注视野外旋减弱(外旋≤14°)。术后全部患者上方、正前方及下方注视野的立体视锐度均由无到有或从粗糙到较精细,立体视锐度从800″到60″呈逐步提高趋势;立体视觉从周边立体视到黄斑立体视,直至正常的黄斑中心凹立体视。手术前、后上方、正前方及下方注视野的立体视觉情况比较,差异均有统计学意义(P<0.05)。结论上斜肌矢状移位术可用于治疗前下方注视野旋转复视症状明显的后天性外旋转斜视;手术不仅使患者消除了实用注视野的旋转复视症状,而且使患者的立体视觉功能得到不同程度提高。     

先天性单侧上斜肌麻痹患者眼底旋转与立体视觉的关系研究

目的 采用眼底照相为客观检查方法,探讨先天性单侧上斜肌麻痹(USOP)患者眼底旋转情况与立体视觉的相关性。方法 收集2018年1月至2021年12月在我院行手术治疗的先天性USOP患者,对其病历资料进行回顾性分析,测量眼底照片中黄斑中心凹-视盘中心夹角(fovea-disc angle FDA),分析眼底旋转状况及FDA大小与患者立体视觉之间的关系。结果 研究共纳入43例USOP患者,35%(15例)眼底正常(双眼均无旋转),65%(28例)眼底外旋。眼底正常组的双眼总FDA为12.62°±3.24°,外旋组为22.74°±8.60°,正常组双眼总FDA明显小于外旋组,P<0.05。眼底正常组和外旋组远近立体视均存在者分别为33%(5例)和7%(2例),差异显著,P<0.05。所有患者双眼总FDA与远、近立体视均存在相关性(r=-0.307,P=0.046,r=-0.326,P=0.033);正常组双眼总FDA与远近立体视无相关性,外旋组双眼总FDA与近立体视存在相关性(r=-0.521,P=0.004);外旋组中单眼外旋患者,其外旋眼FDA与远近立体视相关程度最高(r=-...     

旋转眼位测量的年龄相关特点

目的探讨儿童黄斑视盘相对位置的发育特点。方法回顾性系列研究。对2013年6月至2014年11月在北京大学第一医院小儿眼科就诊的37名3岁儿童及40名6岁儿童进行眼底照相,分别测量分析旋转眼位的相关参数,包括视盘直径测量,黄斑-视盘水平、垂直距离的测量,黄斑视盘夹角的计算等,并进行统计学分析。结果3岁年龄组：视盘水平径测量值平均为（1．91±0．17）mm;垂直径测量值平均为（2．06±0．21）mm。黄斑中心凹距视盘中心的水平距离平均为（5．24±0．27）mm,垂直距离平均为（0．63±0．33）mm。以视盘直径为单位（1PD）计算的黄斑中心凹位置在视盘颞侧（2．74±0．27）PD,中心以下（0．30±0．15）PD。黄斑一视盘夹角为（6．82±3．57）°。6岁年龄组：视盘水平径平均测量值为（1．88±0．19）mm;垂直径平均测量值为（2．01±0．19）mm。黄斑中心凹距视盘中心的水平距离为（5．06±0．26）mm,垂直距离为（0．54±0．30）mm。以视盘直径（PD）为单位计算的黄斑中心凹位置在视盘颞（2．71±0．28）PD,中心以下（0．27±0．16）PD。黄斑-视盘夹角为（6．22±3．58）°。以上测量值的两个年龄组比较,黄斑中心凹距视盘中心的水平距离差别具有统计学意（P〈0．01）。结论儿童眼底照相结果表现视盘大小变异较大,黄斑-视盘垂直距离的实际测量值也存在较大个体差异。黄斑-视盘夹角的测量没有年龄差异,在研究或诊治低龄儿旋转斜视时可以不考虑年龄因素。     

近视及近视性弱视儿童视网膜神经纤维层OCT检测及分析

目的分析近视及近视性弱视儿童视网膜光学相干断层扫描（OCT）各项指标的变化,研究近视及近视性弱视儿童的视网膜结构的变化特征。方法对52只眼近视性弱视组和32只眼单纯近视组行视网膜OCT检查,记录黄斑中心凹中心视网膜厚度和视盘上方、下方、鼻侧、颞侧及平均视网膜神经纤维层（RNFL）厚度,并与32只眼正常对照组进行比较。结果近视性弱视组和正常对照组比较,视盘下方和视盘周围平均RNFL厚度变薄,且有统计学意义（P〈0.05）,而视盘上方、颞侧和鼻侧RNFL厚度和黄斑中心凹中心视网膜厚度均无显著差异（P〉0.05）。单纯近视组和正常对照组比较,视盘周围RNFL厚度和黄斑中心凹视网膜厚度均无显著差异（P〉0.05）。近视性弱视组高度近视儿童的视盘上方、下方、鼻侧和视网膜平均RNFL厚度较健眼变薄（P〈0.05）,而颞侧和黄斑中心凹中心视网膜厚度无明显变化（P〉0.05）,单纯近视组中高度近视儿童的视盘颞侧RNFL层厚度和黄斑中心凹中心视网膜厚度增加明显（P〈0.05）。结论近视及近视性弱视儿童的视网膜结构存在异常。     

旋转性斜视角度的客观检查

旋转性斜视角度测量分为主观检查及客观检查.旋转性斜视角度客观检查可通过检查测量眼底视盘—黄斑中心凹夹角确定.文中综述视盘—黄斑中心凹夹角测量对旋转性斜视的诊断及判断手术预后的作用.     

散光眼与视力相关性分析

目的　了解散光与视力的关系。方法　根据不同年龄段选择不同散瞳剂散瞳 ,用带状光检影镜作屈光检查 (4 0岁以上者无需散瞳 ) ,对检查结果及视力情况进行分析。结果　 136 0只眼中轻度散光 90 4只眼 (6 6 .4 7% ) ,中度散光 35 6只眼 (2 6 .18% ) ,高度散光 10 0只眼 (7.35 % ) ,裸视力大部分≤ 4 .5有 5 4 6只眼 (4 0 .15 % ) ,矫正视力≥ 5 .0有 732只眼 (5 3.82 % )。其中轻度散光 6 0 8只眼 (4 4 .71% )。高度散光有 14眼 (1.0 3% )。散光轴向 90°的有 4 85只眼 ,散光轴向 180°的有 4 97只眼 ,斜轴的有 378只眼。结论　高度散光及斜轴散光度对视力影响较大 ,轻度散光大多数矫正视力可达正常标准 ,高度散光尤其是长大成人后才开始配戴眼境的患者矫正视力差 ,并容易形成弱视。     

远视性弱视儿童视网膜神经纤维层厚度分析

目的研究远视性弱视儿童视盘周围视网膜神经纤维层（RNFL）厚度和黄斑中心凹厚度的变化,并与单眼弱视儿童对侧正常眼的检查结果进行比较。方法对32例（41只眼）远视性弱视儿童和18例（18只眼）单眼弱视儿童对侧正常眼进行光学相干断层扫描（OCT）检查,记录视盘周围RNFL的平均厚度和黄斑中心凹的视网膜厚度。结果远视性弱视组和对照组视盘周围RNFL的平均厚度分别为118.77±11.43μm和109.12±11.09μm,两者相比,差异有统计学意义;远视性弱视组和对照组黄斑中心凹处视网膜厚度分别为155.98±29.30μm和147.28±13.11μm,两组之间无明显差异（P=0.121）。将弱视分组发现,轻度弱视组和中度弱视组的视盘周围RNFL的平均厚度分别为118.42±10.95μm和119.12±12.19μm,,黄斑中心凹处视网膜厚度分别为154.29±34.23μm和157.75±23.81μm。两者分别与对照组比较,视盘周围RNFL厚度差异有统计学意义;黄斑中心凹视网膜厚度差异无统计学意义（P=0.777,0.629）。结论远视性弱视儿童视盘周围RNFL变厚,而黄斑视网膜厚度无明显变化。     

下斜肌减弱术对眼球客观旋转角度的影响

目的:分析下斜肌减弱术对第一眼位眼球客观旋转角度所产生的影响。方法:收集我院2008年以来各种类型斜视患者中下斜肌功能亢进者需行手术治疗的患者23例30眼。应用Stratus OCTTM3000扫描仪于术前及术后1wk对患眼进行眼底扫描及图像拍摄,获取眼底图像。将所拍摄图像应用Photoshop进行分析处理,测得视盘-黄斑中心凹夹角即该眼球的客观旋转角。结果:术前及术后外旋角度比较,术前为17.200°±6.624°,术后为7.735°±6.545°,术前与术后眼球旋转角度比较,差异有显著统计学意义(P<0.01)。结论:行下斜肌减弱术可明显改变眼球在第一眼位的客观外旋转角度。本研究所得的结果即下斜肌减弱术对第一眼位眼球客观旋转角度影响的范围,对旋转斜视患者术前手术设计及预后估计具有一定的参考价值。     

对称下斜肌后徙术治疗原发不对称性下斜肌亢进

目的 探讨对称的下斜肌后徙术治疗正前方无明显垂直斜视的原发不对称性下斜肌亢进的手术疗效.方法 回顾性分析了2004年7月至2010年8月住院行对称下斜肌后徙术的34例原发不对称性下斜肌功能亢进患者,术前一只眼的下斜肌亢进程度为+1～+2;另一只眼的下斜肌亢进程度为+3～+4.手术前后分别观察患者的双眼下斜肌功能、A-V征、代偿头位、双眼视功能和旋位.术后随访6个月～12个月.结果 术后双眼下斜肌功能正常的30例,所有患者均没有出现下斜肌功能不足;术前24例有V征,术后V征均消失;术前外旋度数为(26.3°±0.5°),术后的外旋度数为(16.2°±3.2°),双眼术后黄斑中心凹-视盘中心夹角度数(FDA)与术前相比有内旋的趋势;术前有双眼视的4例,术后有双眼视的7例;术前6例有代偿头位,术后3例代偿头位消失,2例代偿头位好转.结论 对称的下斜肌后徙术对改善下斜肌功能和治疗由原发不对称性下斜肌亢进所引起的V征、旋位、代偿头位以及恢复双眼视功能均安全有效.

Abstract：

Objective To evaluate the effects of bilateral symmetric inferior oblique recession on the patients with bilateral asymmetric primary infenor oblique overaction and without vertical misalign ment in the primary position. Methods A retrospective study was carried on 34 patients with bilateral asymmetric inferior oblique overaction admitted to the hospital from July of 2004 to August of 2010;inferior oblique overaction before surgery were of grade -1 0r -2 in one eye and -3 0r 4 in the oth er. The degrees of inferior oblique overaction A-V pattem, degrees of fundus torsion binocular sight and abnormal heads were analyzed in all patients before and after surgery. The patients were fol lowed-up for 6 to 12 months after the surgery. Results Symptoms of the inferior oblique overaction disappeared completely in 30 patients, none of the patients showed underaction of inferior oblique muscle function; 24 cases had V strabismus before surgery, their symptoms disappeared after surgery;the degrees of fundus torsion were 26.3°± 0.5° before surgery and 16.2°± 32° after surgery; the fovea - to- disc angle (FDA) after the surgery had a tendency to incyclotorsion when compared to tbat before surgery 4 patients with binocular sight before surgery and 7 patients after surgery abnormal head position was present in 6 patients before surgery it disappeared in 3 and improved in 2 after the surgery. Conclusions Compared to primary asymmetric inferior oblique overaction, bilateral symmetric inferior oblique recession may bave modifying inferior oblique function and may have a better effect on the V strabismus, degree of fundus torsion, abnormal heads and rebuilt binocular sight function which caused by inferior oblique overaction.     

Determination of the location of the fovea on the fundus

PURPOSE: To evaluate whether the distance between optic nerve head and fovea in healthy eyes determined by scanning laser ophthalmoscope may facilitate estimation of the location of the fovea relative to the optic disc in patients with macular disease. METHODS: The angular distance was measured, in horizontal and vertical directions, between the center of the optic nerve head and the fovea in 104 eyes of 104 healthy probands. For additional evaluation of intraindividual variation in 70 of these persons the contralateral eye was measured as well. RESULTS: The distance between the optic disc and the fovea differed vertically more than horizontally (-1.5 +/- 0.9 degrees [-3.65 to +0.65 degrees ] vs. 15.5 +/- 1.1 degrees [13.0-17.9 degrees ]). There was a mean angle between the fovea and the center of the optic disc versus the horizon of -5.6 +/- 3.3 degrees. The intraindividual difference between right and left eyes was markedly lower, with average angles being 0.2 +/- 1.3 degrees vertically and 0.0 +/- 1.1 degrees horizontally. CONCLUSIONS: The distance between the optic nerve head and the fovea does not allow for a meaningful determination of the location of the fovea in eyes in which morphologic changes have occurred. The angle of rotation of the fovea relatively to the center of the optic nerve head is relatively stable. Therefore, the size of a central scotoma can be determined by movement of the blind spot according to the change of the preferred retinal locus (PRL). In addition, the knowledge of the location of the fovea enables determination of the position in the contralateral eye of the same patient.     

Torsion as a contributing cause of the anti-elevation syndrome.

BACKGROUND: The anti-elevation syndrome is an adverse outcome of anterior transposition of the inferior oblique muscle. The presumed cause is an excessive anti-elevating force vector that occurs with attempted elevation in abduction. This causes apparent overaction of the contralateral inferior oblique muscle due to fixation duress. It has been suggested that excessive residual extorsion may help explain this phenomenon. METHODS: Fundus photographs to assess torsion were evaluated by masked observers in 18 patients who had undergone anterior transposition of the inferior oblique muscle. Eight of the patients were found to have the anti-elevation syndrome and 10 were not. RESULTS: Patients with the anti-elevation syndrome had more extorsion (mean, 16.6 degrees +/- 3.4 degrees ) than the patients who did not have the anti-elevation syndrome (mean, 8.8 degrees +/- 2.3 degrees ). This difference was significant (P < .0001). In addition, 2 patients who initially did not show the anti-elevation syndrome were found to have an increase in their fundus extorsion after they subsequently developed the anti-elevation syndrome. Two patients who had the anti-elevation syndrome showed a marked decrease in fundus extorsion after the anti-elevation syndrome was surgically eliminated by converting the anterior transposition to a simple recession. CONCLUSION: The presence of substantial extorsion may contribute to the cause of the anti-elevation syndrome after inferior oblique muscle anterior transposition. Lateral placement of the posterior (lateral) corner of the inferior oblique muscle at the time of surgery may cause substantial extorsion after surgery.     

Evaluating the eye's rotational stability during standard photography: effect on determining the axial orientation of toric intraocular lenses

PURPOSE: To evaluate the rotational stability of the eye during standard photography and determine its effect on the measurement of toric intraocular lens (IOL) orientation. SETTING: Department of Ophthalmology, University Erlangen-Nuremberg, Erlangen, Germany. METHODS: The rotational stability of the eye was evaluated using standard photographs taken with a telecentric fundus camera (Zeiss). Two sets of fundus images were taken at least 6 months apart in 400 eyes of 200 patients. The axial position of the eye was determined using 2 characteristic markers of the fundus. The angle between the 2 images (autorotation angle) was measured in each eye. RESULTS: The mean absolute autorotation was 2.3 degrees +/- 1.7 (SD) (range 0 to 11.5 degrees). Nine percent of eyes did not rotate. The rotation was less than 3 degrees in 55% of eyes and was 3 degrees or greater in 36% of eyes. Eyes of patients younger than 50 years rotated less than eyes in older patients (mean 2.2 +/- 1.5 degrees and 2.5 +/- 1.8 degrees, respectively) (P=.04). A visual acuity of 20/20 or better (P=.02) and a refractive cylinder of less than 1.75 diopters (P=.01) were correlated with smaller amounts of autorotation. Potential causes of artificial eye rotation induced by the photographic technique included camera adaptation (3-degree intrinsic error), slide mounting (<1 degree), slide projection (<0.5 degree), marking of characteristic fundus details (<1 degree), and head inclination. CONCLUSIONS: Cyclorotation of the eye during standard photography may lead to overestimation or underestimation of the presumed spontaneous rotation of an implanted toric IOL. Results show that 11.5 degrees of toric IOL rotation would lead to residual astigmatism that is 40% of the initial astigmatic power and 3 degrees, 10% of the initial power. Digital imaging may reduce the intrinsic errors of standard photography.     

Astigmatic axis and amblyopia in childhood

PURPOSE: This study is part of a larger project whose aim is to evaluate the relationship between refractive errors and amblyopia. In an earlier study, we showed that there is a substantial increase in the prevalence of amblyopia among children with oblique astigmatism. To further evaluate this relationship, we examined children with astigmatisms of 1 dioptre or more and varying directions of the astigmatic axes. METHODS: Two groups of astigmatic children, with oblique and orthogonal astigmatism, respectively, were selected for the study at 1 year of age via a general health screening programme. The most emmetropic axis was identified in each child and used in the study. Visual acuity (VA) was tested when the children were between 4 and 4.5 years of age. The presence of amblyopia, defined as difference in VA between the eyes of 0.1 log unit or more, and any increase in acuity following occlusion therapy were noted. RESULTS: The angle of the astigmatic axis strongly relates to the risk of developing amblyopia. Axes +/- 15 degrees from the main axes did not affect the risk of amblyopia but oblique astigmatism significantly increased the risk of developing amblyopia (p = 0.0024). CONCLUSIONS: The results accord with earlier findings that oblique astigmatism increases the risk of developing amblyopia.     

下斜肌减弱术对眼球旋转状态的影响

目的　了解主、客观旋转检查结果的临床意义 ,探讨下斜肌减弱术对眼球旋转状态的影响。方法　对 2 0例 (40只眼 )下斜肌功能亢进患者行双眼下斜肌切断或部分切除术 ,应用双马氏杆试验 (DMRT)检查术前、术后 1周及术后 2个月术眼的主观旋转度数 ;术前和术后 1周对其中 15例 (30只眼 )患者行眼底照像 ,并使用绘图软件测量黄斑 视乳头夹角度数 ,记录术眼的客观旋转度数。结果　 9例原发性下斜肌功能亢进患者术前DMRT均阴性 ,术后 2个月 1例主观内旋转 5 0°;在 11例下斜肌继发性亢进患者中 ,4例术前DMRT外旋转 2 5°～ 5 0°,术后 2个月 11例均无主观旋转度数。眼底照像示全部患者左、右眼平均客观旋转度数术前分别为外旋转 14 92°± 4 5 1°和外旋转 16 83°± 6 39°,下斜肌减弱手术后 1周分别减少 10 5 4°± 3 75°和 13 0 7°± 3 38° ;双眼手术前、后客观旋转度数比较 ,差异均有非常显著意义 (P <0 0 1)。结论　原发性或出生早期继发性下斜肌功能亢进患者主、客观旋转检查结果不一致。下斜肌减弱术可矫治眼球外旋转斜视 ;术后主观旋转状态的变化存在复杂的代偿机制 ;主、客观旋转状态的变化仍存在不一致性。     

Surgical outcomes of intermittent exotropia associated with concomitant hypertropia including simulated superior oblique palsy after horizontal muscles surgery only

PURPOSE: To investigate the clinical features and obtain guideline of treatment in intermittent exotropia associated with hypertropia including simulated superior oblique palsy. METHODS: We retrospectively reviewed the charts of 93 patients of intermittent exotropia aligned with horizontal muscle surgery only, who showed hypertropia more than 2 PD in primary gaze before surgery and disappeared after surgery. They showed forveal extorsion and dysfunction of oblique muscles of 2+ or less and positive Bielschowsky head tilt test. The postoperative changes of deviation angle were analysed at postoperative 1 day, 6 months, and 1 year. RESULTS: Average amount of distant horizontal deviation in primary gaze was 32.3+/-9.58 (25-53) PD, hypertropia was 3.50+/-2.52 (2-14) PD. Average vertical deviation of ipsilateral (hypertropic eye) side was 8.8+/-4.63 PD and contralateral (hypotrophic eye) side was 4.0+/-4.77 PD in Bielschowsky head tilt test. Hypertropic eye was accorded with exotropic eye in 53.4%. After horizontal surgery, the amount of hypertropia was 1.2 PD at postoperative 1 day. On Bielschowsky head tilt test, hypertropia was almost eliminated showing 0.6 PD on the ipsilateral side and 0.2 PD on the contralateral eye at 1 month. This state was maintained up to postoperative 1 year. CONCLUSION: Small amount of hypertropia up to 14 PD in intermittent exotropia could be disappeared with horizontal muscle surgery only. However, careful examinations for head tilt history, fovea extorsion, oblique dysfunction, and Maddox rod test should be preceded to rule out true superior oblique palsy.     

Peripheral refraction for distance and near vision in emmetropes and myopes

We investigated the relationship between myopia and peripheral refraction for distance and near vision by measuring peripheral refractive errors in 10 myopic and 10 emmetropic participants at viewing distances of 2.5 and 0.4 m. Measurements were made at the fovea, and at eccentricities of 10 degrees , 20 degrees and 30 degrees in the temporal and nasal hemispheres of the horizontal visual field. Our results showed that peripheral astigmatism increased with increasing eccentricity, but there was no significant difference between refractive error groups except at 30 degrees eccentricity in the temporal retina. Considering the Mean Spherical Equivalent errors, emmetropes became relatively myopic at peripheral eccentricities, but there was little change in myopes. The effect of viewing distance on astigmatism or Mean Spherical Equivalent error was not significant. Our results do not support the view that myopia is associated with changes in peripheral refraction during distance or near vision.     

散光患者的角膜散光轴位与总合散光轴位的分析

目的通过统计分析屈光不正患者总合散光的轴位与角膜散光的轴位的关系和大小,为验光配镜、隐形眼镜的基弧及散光性隐形跟镜的轴位选择、准分子激光的手术量计算提供参考.方法对107例屈光不正患者,用同一电脑验光仪对其同时、同眼、同状态的情况下作屈光状态的测定及角膜曲率的测定,每人重复3次,通过电脑记录,得出总合散光及角膜散光的轴位,进行统计分析.结果近视患者的总合散光轴位与角膜散光的轴位的夹角是5.73°±3.97°,混合散光患者的总合散光轴位与角膜散光的轴位夹角为3.13°±2.49°,远视患者的总合散光轴位与角膜散光的轴位夹角为6.35°±4.20°.结论眼屈光状态中总合散光的轴位与角膜散光的轴位所构成的夹角主要是由于晶体及角膜内表面散光的轴位不一致所引起.眼科学报2000;16279～280.